Provider Demographics
NPI:1821045634
Name:POWER WHEELCHAIRS OF AMERICA, INC.
Entity Type:Organization
Organization Name:POWER WHEELCHAIRS OF AMERICA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRESTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-483-2112
Mailing Address - Street 1:575 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CANDIA
Mailing Address - State:NH
Mailing Address - Zip Code:03034-2022
Mailing Address - Country:US
Mailing Address - Phone:603-483-2112
Mailing Address - Fax:603-483-2114
Practice Address - Street 1:575 HIGH ST
Practice Address - Street 2:
Practice Address - City:CANDIA
Practice Address - State:NH
Practice Address - Zip Code:03034-2022
Practice Address - Country:US
Practice Address - Phone:603-483-2112
Practice Address - Fax:603-483-2114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
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
A08010472Medicare ID - Type UnspecifiedMEDICARE SUBMITTER NUMBER
5327570001Medicare NSC