Provider Demographics
NPI:1902190150
Name:PSYCHE C-PAP PILLOW, LLC
Entity Type:Organization
Organization Name:PSYCHE C-PAP PILLOW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:DEETSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-693-1037
Mailing Address - Street 1:208 LINNEY AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1014
Mailing Address - Country:US
Mailing Address - Phone:502-693-1037
Mailing Address - Fax:
Practice Address - Street 1:208 LINNEY AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1014
Practice Address - Country:US
Practice Address - Phone:502-693-1037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment