Provider Demographics
NPI:1639478282
Name:ROOSTER RIDGE STAIRLIFTS, LLC
Entity Type:Organization
Organization Name:ROOSTER RIDGE STAIRLIFTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-877-2558
Mailing Address - Street 1:PO BOX 1278
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-1278
Mailing Address - Country:US
Mailing Address - Phone:336-877-2558
Mailing Address - Fax:
Practice Address - Street 1:500 ROOSTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:NC
Practice Address - Zip Code:28643-9167
Practice Address - Country:US
Practice Address - Phone:336-384-2415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty