Provider Demographics
NPI:1922475193
Name:C-PRO MEDICAL ALERT
Entity Type:Organization
Organization Name:C-PRO MEDICAL ALERT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF ACCOUNTS
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MICHELSEN
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:208-319-6806
Mailing Address - Street 1:6918 NOAH CT
Mailing Address - Street 2:#102
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-5288
Mailing Address - Country:US
Mailing Address - Phone:208-319-6806
Mailing Address - Fax:
Practice Address - Street 1:390 E CORPORATE DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-3500
Practice Address - Country:US
Practice Address - Phone:208-319-6806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID333300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies