Organization
FOURTH DIMENSION CORP
Active
Other names
Authorized Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A LANTZ (DIRECTOR)
(541) 647-7762
Entity
Organization
Contact information
Practice address
61148 BENHAM RD, BEND, OR 97702-2652
(541) 383-2364
(541) 383-2364
Mailing address
61148 BENHAM RD, BEND, OR 97702-2652
(541) 383-2364
(541) 383-2364
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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