Provider Demographics
NPI:1053372581
Name:SAM BAXTER AND COMPANY INC
Entity type:Organization
Organization Name:SAM BAXTER AND COMPANY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-480-3553
Mailing Address - Street 1:1842 KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-2610
Mailing Address - Country:US
Mailing Address - Phone:757-480-3553
Mailing Address - Fax:757-333-6855
Practice Address - Street 1:1842 KINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-2610
Practice Address - Country:US
Practice Address - Phone:757-480-3553
Practice Address - Fax:757-333-6855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies