Provider Demographics
NPI:1821634288
Name:WHITE CONSULTING, LLC DBA MOHAWK DME
Entity Type:Organization
Organization Name:WHITE CONSULTING, LLC DBA MOHAWK DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-358-1419
Mailing Address - Street 1:447 FROGTOWN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:AKWESASNE
Mailing Address - State:NY
Mailing Address - Zip Code:13655-3229
Mailing Address - Country:US
Mailing Address - Phone:518-358-1419
Mailing Address - Fax:
Practice Address - Street 1:447 FROGTOWN RD STE 102
Practice Address - Street 2:
Practice Address - City:AKWESASNE
Practice Address - State:NY
Practice Address - Zip Code:13655-3229
Practice Address - Country:US
Practice Address - Phone:518-358-1419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies