Provider Demographics
NPI:1700918935
Name:TRAK DME CORPORATION
Entity Type:Organization
Organization Name:TRAK DME CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:EKPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-625-0169
Mailing Address - Street 1:200 ELM ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2715
Mailing Address - Country:US
Mailing Address - Phone:603-625-0169
Mailing Address - Fax:866-411-1809
Practice Address - Street 1:200 ELM ST
Practice Address - Street 2:SUITE 7
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2715
Practice Address - Country:US
Practice Address - Phone:603-625-0169
Practice Address - Fax:866-411-1809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5418920001Medicare NSC