Healthcare Provider Details

I. General information

NPI: 1063640597
Provider Name (Legal Business Name): UNITED FAMILY MEDICAL SUPPLY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20524 WISTERIA ST
CASTRO VALLEY CA
94546-5523
US

IV. Provider business mailing address

2836 E COGHILL TER
DUBLIN CA
94568-1189
US

V. Phone/Fax

Practice location:
  • Phone: 510-727-9169
  • Fax: 510-727-9176
Mailing address:
  • Phone: 510-673-1785
  • Fax: 925-828-2088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIANA ULEP TABURAZA
Title or Position: VICE PRESIDENT
Credential:
Phone: 510-673-1785