Provider Demographics
NPI:1588148134
Name:DONDELL INC.
Entity type:Organization
Organization Name:DONDELL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIPPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-343-4242
Mailing Address - Street 1:125 S CURTIS RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-1014
Mailing Address - Country:US
Mailing Address - Phone:208-343-4242
Mailing Address - Fax:208-343-6764
Practice Address - Street 1:2102 CALDWELL BLVD STE 116
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-1513
Practice Address - Country:US
Practice Address - Phone:208-343-4242
Practice Address - Fax:208-343-6764
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DONDELL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-19
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier