Provider Demographics
NPI:1801049663
Name:MINDNAUTILUS.COM CORPORATION DBA ENABLEMART
Entity type:Organization
Organization Name:MINDNAUTILUS.COM CORPORATION DBA ENABLEMART
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE
Authorized Official - Prefix:MS
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-281-7677
Mailing Address - Street 1:5353 S 960 E STE 200
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-3576
Mailing Address - Country:US
Mailing Address - Phone:801-281-7677
Mailing Address - Fax:
Practice Address - Street 1:5353 S 960 E STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-3576
Practice Address - Country:US
Practice Address - Phone:801-281-7677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINDNAUTILUS.COM CORPORATION DBA ENABLEMART
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies