Theo Wholesale LLC

Primary specialty

Research Clinic/CenterTaxonomy code 261QR1100X

Legal business name

THEO WHOLESALE LLC

Practice address

30 N Gould St Ste N
Sheridan, WY 82801-6317

Phone

(208) 892-9780

NPI assigned

Jan 20, 2026

Last updated

Jan 20, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Theodore Dennis Becker, N/A

Title

Ceo

Phone

(208) 892-9780

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1457210825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N GOULD ST STE N",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828016317",
            "telephone_number": "208-892-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N GOULD ST STE N",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828016317",
            "telephone_number": "208-892-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEO WHOLESALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-892-9780",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Research Clinic/Center in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Research Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.