Organization
ACTIVE ADULT HOME HEALTH CARE EQUIPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VASILI MERABISHVILI (PRESIDENT)
(801) 412-2603
Entity
Organization
Contact information
Practice address
970 E 3300 S, 8, SALT LAKE CITY, UT 84106-2183
(801) 412-2603
(801) 413-2603
Mailing address
970 E 3300 S, 8, SALT LAKE CITY, UT 84106-2183
(801) 412-2603
(801) 413-2603
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
51492
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51492
BUSENESS LICENSE
UT
Enumeration date
12/13/2007
Last updated
12/13/2007
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