Provider Demographics
NPI:1639119431
Name:BARENABA INC.
Entity Type:Organization
Organization Name:BARENABA INC.
Other - Org Name:GRANDVIEW MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:MOSES
Authorized Official - Last Name:BARENABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-356-0322
Mailing Address - Street 1:887 S 50 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-7029
Mailing Address - Country:US
Mailing Address - Phone:801-356-0322
Mailing Address - Fax:801-356-0322
Practice Address - Street 1:887 S 50 E
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-7029
Practice Address - Country:US
Practice Address - Phone:801-356-0322
Practice Address - Fax:801-356-0322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========001Medicaid