Organization
SCOOTER WAREHOUSE INC.
Active
Organization
SCOOTER WAREHOUSE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA MOORE (PRESIDENT)
(574) 299-8606
Entity
Organization
Contact information
Practice address
4011 S MICHIGAN ST, SOUTH BEND, IN 46614-2543
(574) 299-8606
(574) 299-0538
Mailing address
4011 S MICHIGAN ST, SOUTH BEND, IN 46614-2543
(574) 299-8606
(574) 299-0538
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
69000243A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000300423
BCBS PIN #
IN
05
—
200454170A
—
IN
Enumeration date
10/04/2005
Last updated
10/02/2009
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