Provider Demographics
NPI:1881860880
Name:PERSONALLY DELIVERED, LLC
Entity Type:Organization
Organization Name:PERSONALLY DELIVERED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIVETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-296-2347
Mailing Address - Street 1:9601 E RAND PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5833
Mailing Address - Country:US
Mailing Address - Phone:520-296-2347
Mailing Address - Fax:
Practice Address - Street 1:9601 E RAND PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-5833
Practice Address - Country:US
Practice Address - Phone:520-296-2347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMP00527332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies