MEDICARE: RECOVERY MEDICAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	2000180-424	NV
2	332B00000X	Durable Medical Equipment & Medical Supplies	BUS2012-02175	CA

General Provider Information

NPI Number	:	1366670655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERY MEDICAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	1630 S SINCLAIR ST
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92806-5927
Country	:	US
Telephone Number	:	657-888-6250
Fax Number	:	657-888-6251

Provider Business Practice Location Address
First Line	:	1630 S SINCLAIR ST
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92806-5927
Country	:	US
Telephone Number	:	657-888-6250
Fax Number	:	657-888-6251

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GLEN CURTIS ALLEN
Credential	:
Telephone Number	:	714-987-2633

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	08/18/2016

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