MEDICARE: DEES HAMPTON MEDICAL SUPPLIES

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	43350	CA

General Provider Information

NPI Number	:	1679595904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEES HAMPTON MEDICAL SUPPLIES

Provider Business Mailing Address
First Line	:	950 N RAMONA BLVD
Second Line	:	SUITE13
City	:	SAN JACINTO
State	:	CA
Zip	:	92582-2567
Country	:	US
Telephone Number	:	951-691-7780
Fax Number	:	951-487-1113

Provider Business Practice Location Address
First Line	:	950 N RAMONA BLVD
Second Line	:
City	:	SAN JACINTO
State	:	CA
Zip	:	92582-2567
Country	:	US
Telephone Number	:	951-691-7780
Fax Number	:	951-487-1113

Authorized Official
Title or Position	:	OWNER
Name	:	DEIRDRA HAMPTON VIII
Credential	:
Telephone Number	:	951-691-7780

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	05/09/2012

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