Provider Demographics
NPI:1669680021
Name:INTERSTATE ALARM & ELECTRIC INC.
Entity Type:Organization
Organization Name:INTERSTATE ALARM & ELECTRIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:SGALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-859-6481
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:TILTONSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43963-0082
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:213 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:TILTONSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43963-1036
Practice Address - Country:US
Practice Address - Phone:740-859-6481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0202506Medicaid