Provider Demographics
NPI:1699975284
Name:TAYLOR ENTERPRISES 2, INC.
Entity type:Organization
Organization Name:TAYLOR ENTERPRISES 2, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROD
Authorized Official - Middle Name:A
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-634-8283
Mailing Address - Street 1:1560 E CHERRY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-3435
Mailing Address - Country:US
Mailing Address - Phone:928-634-8283
Mailing Address - Fax:928-649-1914
Practice Address - Street 1:1560 E CHERRY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-3435
Practice Address - Country:US
Practice Address - Phone:928-634-8283
Practice Address - Fax:928-649-1914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20174041332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ6008510001Medicare NSC