Provider Demographics
NPI:1669573416
Name:HGNS INVESTMENTS
Entity type:Organization
Organization Name:HGNS INVESTMENTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHRYSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-522-6433
Mailing Address - Street 1:859 S YELLOWSTONE HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-5293
Mailing Address - Country:US
Mailing Address - Phone:208-522-6433
Mailing Address - Fax:208-522-8443
Practice Address - Street 1:859 S YELLOWSTONE HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-5293
Practice Address - Country:US
Practice Address - Phone:208-522-6433
Practice Address - Fax:208-522-8443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID5668740001Medicare ID - Type UnspecifiedPROVIDER NUMBER