Basic Information
| Provider Information | |||||||||
| NPI: | 1114091667 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WHEELCHAIR WORKS INC | ||||||||
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| OtherOrganizationName: | NUMOTION | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 TRIBUTE RD | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958154400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164893651 | ||||||||
| FaxNumber: | 9164891444 | ||||||||
| Practice Location | |||||||||
| Address1: | 4211 SE INTERNATIONAL WAY | ||||||||
| Address2: | SUITE C | ||||||||
| City: | MILWAUKIE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972228824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036544333 | ||||||||
| FaxNumber: | 5036548330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2006 | ||||||||
| LastUpdateDate: | 05/16/2016 | ||||||||
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| AuthorizedOfficialLastName: | FEITEL | ||||||||
| AuthorizedOfficialFirstName: | TAMAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8602573443 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |
ID Information
| ID | Type | State | Issuer | Description | 139265 | 01 | DOLI | OTHER | 132662000 | 01 | OWCP | OTHER | 226325 | 05 | OR | MEDICAID | K1050-01 | 01 | PACIFIC SOURCE | OTHER | 226325 | 01 | NORTH WEST HOME CARE | OTHER | 86091000 | 01 | BCBS FEDERAL | OTHER | 86091000 | 01 | OR | REGENCE BCBS OF OREGON | OTHER | 9049388 | 01 | DSHS 1 | OTHER |