Provider Demographics
NPI:1528675469
Name:ANTELOPE WORKS, LLC
Entity type:Organization
Organization Name:ANTELOPE WORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-456-6896
Mailing Address - Street 1:24 W CAMELBACK RD # A586
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-2529
Mailing Address - Country:US
Mailing Address - Phone:602-456-6896
Mailing Address - Fax:
Practice Address - Street 1:2601 N 3RD ST STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1145
Practice Address - Country:US
Practice Address - Phone:602-456-6896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies