Provider Demographics
NPI:1861464588
Name:TIMBER RIDGE INC
Entity Type:Organization
Organization Name:TIMBER RIDGE INC
Other - Org Name:FITTINGS UNLIMITED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-362-8062
Mailing Address - Street 1:402 10TH ST SE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2435
Mailing Address - Country:US
Mailing Address - Phone:319-362-8062
Mailing Address - Fax:319-362-1174
Practice Address - Street 1:402 10TH ST SE
Practice Address - Street 2:SUITE 500
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2435
Practice Address - Country:US
Practice Address - Phone:319-362-8062
Practice Address - Fax:319-362-1174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA01602OtherBCBS OF IA
IA0453902Medicaid
IAIA0100OtherJ DEERE HEALTHCARE
IA0453902Medicaid