Provider Demographics
NPI:1598220022
Name:SILLECT 360 INC
Entity Type:Organization
Organization Name:SILLECT 360 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TY
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:HECKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-706-9444
Mailing Address - Street 1:5610 ROSADO CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-7477
Mailing Address - Country:US
Mailing Address - Phone:661-706-9444
Mailing Address - Fax:
Practice Address - Street 1:5610 ROSADO CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-7477
Practice Address - Country:US
Practice Address - Phone:661-706-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)