Provider Demographics
NPI:1760111207
Name:EKKO HQ, INC.
Entity Type:Organization
Organization Name:EKKO HQ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MS AEROSPACE
Authorized Official - Phone:916-225-3144
Mailing Address - Street 1:150 NE HAWTHORNE AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4690
Mailing Address - Country:US
Mailing Address - Phone:916-225-3144
Mailing Address - Fax:
Practice Address - Street 1:150 NE HAWTHORNE AVE STE 112
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4690
Practice Address - Country:US
Practice Address - Phone:916-225-3144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No251E00000XAgenciesHome Health