Provider Demographics
NPI:1144335589
Name:AUDCON GROUP OF COMPANIES, INC.
Entity type:Organization
Organization Name:AUDCON GROUP OF COMPANIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:UCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-717-6182
Mailing Address - Street 1:4703 BROOKS ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-4725
Mailing Address - Country:US
Mailing Address - Phone:909-625-5474
Mailing Address - Fax:909-625-5830
Practice Address - Street 1:4703 BROOKS ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-4725
Practice Address - Country:US
Practice Address - Phone:909-625-5474
Practice Address - Fax:909-625-5830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45895332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03370FMedicaid
CA5760360001Medicare NSC