Provider Demographics
NPI:1861798506
Name:TOSPRO MEDICAL PRODUCTS, LLC
Entity type:Organization
Organization Name:TOSPRO MEDICAL PRODUCTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:A
Authorized Official - Last Name:NEWKIRK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-819-3179
Mailing Address - Street 1:6 NINA CT
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3209
Mailing Address - Country:US
Mailing Address - Phone:415-819-3179
Mailing Address - Fax:707-540-6072
Practice Address - Street 1:6 NINA CT
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3209
Practice Address - Country:US
Practice Address - Phone:415-819-3179
Practice Address - Fax:707-540-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA027404332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment