Provider Demographics
NPI:1760599088
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:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAIMOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-687-8816
Mailing Address - Street 1:3443 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-2662
Mailing Address - Country:US
Mailing Address - Phone:805-687-8816
Mailing Address - Fax:800-687-2307
Practice Address - Street 1:3443 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-2662
Practice Address - Country:US
Practice Address - Phone:805-687-8816
Practice Address - Fax:800-687-2307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103653332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies