Provider Demographics
NPI:1942484951
Name:PAITSON BROS HARDWARE CO INC
Entity Type:Organization
Organization Name:PAITSON BROS HARDWARE CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:PROCARIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-232-2332
Mailing Address - Street 1:2700 WABASH AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-1510
Mailing Address - Country:US
Mailing Address - Phone:812-232-2332
Mailing Address - Fax:812-232-1266
Practice Address - Street 1:2700 WABASH AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-1510
Practice Address - Country:US
Practice Address - Phone:812-232-2332
Practice Address - Fax:812-232-1266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies