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Organization

CONVERTABATH, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEANNINE S DINGES (PRESIDENT)
(480) 656-1348
Entity
Organization

Contact information

Practice address
1605 W UNIVERSITY DR, SUITE 109, TEMPE, AZ 85281-3267
(480) 646-1348
(480) 446-7015
Mailing address
1605 W UNIVERSITY DR, SUITE 109, TEMPE, AZ 85281-3267
(480) 646-1348
(480) 446-7015

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
259082
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20096376
STATE RESALE BUSINESS LICENSE
AZ
01
259082
ARIZONA REGISTRAR OF CONTRACTORS LICENSE
AZ
Enumeration date
01/27/2011
Last updated
01/27/2011
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