Provider Demographics
NPI:1174892129
Name:SMALL DOG ELECTRONICS INC.
Entity type:Organization
Organization Name:SMALL DOG ELECTRONICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-496-7171
Mailing Address - Street 1:1673 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAITSFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05673-8006
Mailing Address - Country:US
Mailing Address - Phone:802-496-7171
Mailing Address - Fax:802-496-6257
Practice Address - Street 1:1673 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAITSFIELD
Practice Address - State:VT
Practice Address - Zip Code:05673-8006
Practice Address - Country:US
Practice Address - Phone:802-496-7171
Practice Address - Fax:802-496-6257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies