Provider Demographics
NPI:1013239409
Name:SCOOTER ON, INC.
Entity Type:Organization
Organization Name:SCOOTER ON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:VACHUSKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-521-1898
Mailing Address - Street 1:1740 FERGUS DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-5855
Mailing Address - Country:US
Mailing Address - Phone:916-521-1898
Mailing Address - Fax:916-783-0607
Practice Address - Street 1:1740 FERGUS DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-5855
Practice Address - Country:US
Practice Address - Phone:916-521-1898
Practice Address - Fax:916-783-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies