Provider Demographics
NPI:1124273792
Name:EAGLE WING PRODUCTS, INC
Entity type:Organization
Organization Name:EAGLE WING PRODUCTS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-255-4817
Mailing Address - Street 1:5334 E PINE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-2113
Mailing Address - Country:US
Mailing Address - Phone:559-255-4817
Mailing Address - Fax:559-252-0786
Practice Address - Street 1:5334 E PINE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-2113
Practice Address - Country:US
Practice Address - Phone:559-255-4817
Practice Address - Fax:559-252-0786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies