Provider Demographics
NPI:1881685196
Name:NATIVE AMERICAN MEDICAL
Entity Type:Organization
Organization Name:NATIVE AMERICAN MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL SALES REP
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:L
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-343-5948
Mailing Address - Street 1:PO BOX 1360
Mailing Address - Street 2:502 MAIN ST
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-1360
Mailing Address - Country:US
Mailing Address - Phone:605-343-5948
Mailing Address - Fax:605-341-8923
Practice Address - Street 1:502 MAIN ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2734
Practice Address - Country:US
Practice Address - Phone:605-343-5948
Practice Address - Fax:605-341-0923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1881685196Medicare UPIN