Provider Demographics
NPI:1699780031
Name:ATS WHEELCHAIR CO., INC.
Entity type:Organization
Organization Name:ATS WHEELCHAIR CO., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:M
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:RIGG
Authorized Official - Suffix:
Authorized Official - Credentials:MS,ATS,CRTS
Authorized Official - Phone:208-672-1500
Mailing Address - Street 1:1610 N ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-1750
Mailing Address - Country:US
Mailing Address - Phone:208-672-1500
Mailing Address - Fax:208-672-1600
Practice Address - Street 1:1610 N ORCHARD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1750
Practice Address - Country:US
Practice Address - Phone:208-672-1500
Practice Address - Fax:208-672-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDDME103332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002626400Medicaid
ID0201370001Medicare ID - Type Unspecified