Provider Demographics
NPI:1548440365
Name:WHITE TIGER ENTERPRISES, INC.
Entity type:Organization
Organization Name:WHITE TIGER ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER/SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:HMDR EXEMPTEE
Authorized Official - Phone:760-357-2777
Mailing Address - Street 1:302 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-2760
Mailing Address - Country:US
Mailing Address - Phone:760-357-2777
Mailing Address - Fax:760-357-2111
Practice Address - Street 1:302 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-2760
Practice Address - Country:US
Practice Address - Phone:760-357-2777
Practice Address - Fax:760-357-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48116332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA48116OtherHMDR
CA48116OtherHMDR