Healthcare Provider Details
I. General information
NPI: 1932553310
Provider Name (Legal Business Name): NNE MEDICAL SUPPLY AND EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/21/2016
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
617 N EUCLID ST
ANAHEIM CA
92801-4623
US
IV. Provider business mailing address
617 N EUCLID ST
ANAHEIM CA
92801-4623
US
V. Phone/Fax
- Phone: 866-759-0683
- Fax: 866-759-0684
- Phone: 714-430-8570
- Fax: 626-337-2006
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHARINA
G
BERROYA
Title or Position: DIRECTOR
Credential:
Phone: 818-209-9172