Provider Demographics
NPI:1063186567
Name:STATS MEDICAL EQUIPMENT, INC.
Entity type:Organization
Organization Name:STATS MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICO
Authorized Official - Middle Name:N
Authorized Official - Last Name:SOMOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-473-5905
Mailing Address - Street 1:8015 64TH LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-6818
Mailing Address - Country:US
Mailing Address - Phone:630-473-5905
Mailing Address - Fax:
Practice Address - Street 1:8015 64TH LN
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-6818
Practice Address - Country:US
Practice Address - Phone:630-473-5905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier