Provider Demographics
NPI:1790723237
Name:PBR INC
Entity Type:Organization
Organization Name:PBR INC
Other - Org Name:MED-EQUIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WALLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TSCHOPP
Authorized Official - Suffix:
Authorized Official - Credentials:PH
Authorized Official - Phone:712-928-3300
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:HARTLEY
Mailing Address - State:IA
Mailing Address - Zip Code:51346-0028
Mailing Address - Country:US
Mailing Address - Phone:712-928-3300
Mailing Address - Fax:712-728-2805
Practice Address - Street 1:714 S GRAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-5730
Practice Address - Country:US
Practice Address - Phone:712-262-2771
Practice Address - Fax:712-262-2776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0207810007Medicare ID - Type Unspecified