Provider Demographics
NPI:1700013026
Name:THREE WISHES, INC.
Entity Type:Organization
Organization Name:THREE WISHES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-873-3755
Mailing Address - Street 1:21184 FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-1938
Mailing Address - Country:US
Mailing Address - Phone:702-873-3755
Mailing Address - Fax:702-871-1894
Practice Address - Street 1:3355 SPRING MOUNTAIN RD
Practice Address - Street 2:SUITE 22, 23
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8639
Practice Address - Country:US
Practice Address - Phone:702-873-3755
Practice Address - Fax:702-871-1894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRC1485332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies