Provider Demographics
NPI:1811281249
Name:THE ORIGINAL WALK IN BATHTUB COMPANY
Entity type:Organization
Organization Name:THE ORIGINAL WALK IN BATHTUB COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-543-5104
Mailing Address - Street 1:38 TOP OF THE RDG
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1734
Mailing Address - Country:US
Mailing Address - Phone:516-543-5104
Mailing Address - Fax:
Practice Address - Street 1:38 TOP OF THE RDG
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1734
Practice Address - Country:US
Practice Address - Phone:516-543-5104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies