Healthcare Provider Details

I. General information

NPI: 1366670655
Provider Name (Legal Business Name): RECOVERY MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 08/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 S SINCLAIR ST
ANAHEIM CA
92806-5927
US

IV. Provider business mailing address

1630 S SINCLAIR ST
ANAHEIM CA
92806-5927
US

V. Phone/Fax

Practice location:
  • Phone: 657-888-6250
  • Fax: 657-888-6251
Mailing address:
  • Phone: 657-888-6250
  • Fax: 657-888-6251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2000180-424
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberBUS2012-02175
License Number StateCA

VIII. Authorized Official

Name: GLEN CURTIS ALLEN
Title or Position: PRESIDENT
Credential:
Phone: 714-987-2633