Provider Demographics
NPI:1902126501
Name:YOUR PERSONAL DEFIBRILLATOR EXPERT, LLC
Entity Type:Organization
Organization Name:YOUR PERSONAL DEFIBRILLATOR EXPERT, LLC
Other - Org Name:GOOD TO BE ALIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:770-364-7237
Mailing Address - Street 1:23B SHELTER COVE LN
Mailing Address - Street 2:100-A
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-3592
Mailing Address - Country:US
Mailing Address - Phone:770-364-7237
Mailing Address - Fax:
Practice Address - Street 1:23B SHELTER COVE LN
Practice Address - Street 2:100-A
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-3592
Practice Address - Country:US
Practice Address - Phone:770-364-7237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies