Provider Demographics
NPI:1669568101
Name:ECLECTEC INNOVATIONS LLC
Entity type:Organization
Organization Name:ECLECTEC INNOVATIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SCHMALTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-459-4893
Mailing Address - Street 1:23702 3RD PL W
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-8693
Mailing Address - Country:US
Mailing Address - Phone:206-459-4893
Mailing Address - Fax:
Practice Address - Street 1:23702 3RD PL W
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-8693
Practice Address - Country:US
Practice Address - Phone:206-459-4893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies