Provider Demographics
NPI:1386716900
Name:TAYLOR ENTERPRISES,INC.
Entity type:Organization
Organization Name:TAYLOR ENTERPRISES,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROD
Authorized Official - Middle Name:A
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-541-9790
Mailing Address - Street 1:1841 E STATE ROUTE 69
Mailing Address - Street 2:SUITE 122
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-5608
Mailing Address - Country:US
Mailing Address - Phone:928-541-9790
Mailing Address - Fax:928-541-9541
Practice Address - Street 1:1841 E STATE ROUTE 69
Practice Address - Street 2:SUITE 122
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-5608
Practice Address - Country:US
Practice Address - Phone:928-541-9790
Practice Address - Fax:928-541-9541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20097788332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5544930001Medicare NSC