Provider Demographics
NPI:1487077335
Name:CONTINENTAL DEFENSE PROTECTION GROUP LLC
Entity type:Organization
Organization Name:CONTINENTAL DEFENSE PROTECTION GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:YARBOROUGH
Authorized Official - Suffix:SR
Authorized Official - Credentials:MA
Authorized Official - Phone:567-661-0500
Mailing Address - Street 1:2145 E SCOTT PARK DRV MS 420
Mailing Address - Street 2:STE 1060
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606
Mailing Address - Country:US
Mailing Address - Phone:567-661-0500
Mailing Address - Fax:567-661-0500
Practice Address - Street 1:2145 E SCOTT PARK DRV MS 420
Practice Address - Street 2:STE 1060
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:567-661-0500
Practice Address - Fax:567-661-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies