Provider Demographics
NPI:1053506204
Name:ELECTROMEDICAL TECHNOLOGIES, INC
Entity type:Organization
Organization Name:ELECTROMEDICAL TECHNOLOGIES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-790-8034
Mailing Address - Street 1:16561 N. 92ND STREET
Mailing Address - Street 2:SUITE D101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-292-8976
Mailing Address - Fax:480-452-1518
Practice Address - Street 1:16561 N. 92ND STREET
Practice Address - Street 2:SUITE D101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-292-8976
Practice Address - Fax:480-452-1518
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTELSOURCE GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-11
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies