Provider Demographics
NPI:1134561830
Name:ISOLITE ENTERPRISES
Entity type:Organization
Organization Name:ISOLITE ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARQUES
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-614-4426
Mailing Address - Street 1:645 W 9TH ST # 110147
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1640
Mailing Address - Country:US
Mailing Address - Phone:310-614-4426
Mailing Address - Fax:
Practice Address - Street 1:645 W 9TH ST # 110147
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-1640
Practice Address - Country:US
Practice Address - Phone:310-614-4426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies