Provider Demographics
NPI:1841456977
Name:ADA TOTAL ACCESS, INC.
Entity type:Organization
Organization Name:ADA TOTAL ACCESS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:W
Authorized Official - Last Name:LARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-698-9290
Mailing Address - Street 1:125 THUNDERBIRD LN
Mailing Address - Street 2:SUITE 5
Mailing Address - City:EAST PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61611-5508
Mailing Address - Country:US
Mailing Address - Phone:309-698-9290
Mailing Address - Fax:309-698-9280
Practice Address - Street 1:125 THUNDERBIRD LN
Practice Address - Street 2:SUITE 5
Practice Address - City:EAST PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61611-5508
Practice Address - Country:US
Practice Address - Phone:309-698-9290
Practice Address - Fax:309-698-9280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies