Provider Demographics
NPI:1568623288
Name:EMPI INC
Entity type:Organization
Organization Name:EMPI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, CORPORATE COMPLIANC
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-734-4742
Mailing Address - Street 1:1430 DECISION ST
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-8553
Mailing Address - Country:US
Mailing Address - Phone:760-734-4742
Mailing Address - Fax:800-419-9477
Practice Address - Street 1:2891 TRICOM ST
Practice Address - Street 2:SUITE D
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-7110
Practice Address - Country:US
Practice Address - Phone:843-764-3600
Practice Address - Fax:843-764-3016
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPI INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-25
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010 78762 3332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies