Provider Demographics
NPI:1740424761
Name:ELDORADO PRODUCTS, INC.
Entity Type:Organization
Organization Name:ELDORADO PRODUCTS, INC.
Other - Org Name:ELDORADO HAIR ETC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-931-3399
Mailing Address - Street 1:7939 HONEYGO BLVD.
Mailing Address - Street 2:BLDG. III, STE. 228
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236
Mailing Address - Country:US
Mailing Address - Phone:410-931-3399
Mailing Address - Fax:410-931-3671
Practice Address - Street 1:7939 HONEYGO BLVD.
Practice Address - Street 2:BLDG. III, STE. 228
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-931-3399
Practice Address - Fax:410-931-3671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03268572335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier