Provider Demographics
NPI:1154514669
Name:BANDZ, INC.
Entity type:Organization
Organization Name:BANDZ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CLIFTON
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:208-784-1178
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:1000 WEST MAIN ST
Mailing Address - City:SMELTERVILLE
Mailing Address - State:ID
Mailing Address - Zip Code:83868-0219
Mailing Address - Country:US
Mailing Address - Phone:208-784-1178
Mailing Address - Fax:208-786-2911
Practice Address - Street 1:1000 WEST MAIN ST.
Practice Address - Street 2:
Practice Address - City:SMELTERVILLE
Practice Address - State:ID
Practice Address - Zip Code:83868-0219
Practice Address - Country:US
Practice Address - Phone:208-784-1178
Practice Address - Fax:208-786-2911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies