Provider Demographics
NPI:1740046259
Name:THERABIONIC INC
Entity type:Organization
Organization Name:THERABIONIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:PASCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-961-0168
Mailing Address - Street 1:1924 SHERWOOD GLN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1772
Mailing Address - Country:US
Mailing Address - Phone:312-961-0168
Mailing Address - Fax:
Practice Address - Street 1:1924 SHERWOOD GLN
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-1772
Practice Address - Country:US
Practice Address - Phone:312-961-0168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies