Healthcare Provider Details

I. General information

NPI: 1457648305
Provider Name (Legal Business Name): TRI SWIFT MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 07/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 S MAYO AVE
COMPTON CA
90221-4316
US

IV. Provider business mailing address

235 E BROADWAY SUITE 424
LONG BEACH CA
90802-3162
US

V. Phone/Fax

Practice location:
  • Phone: 626-219-6280
  • Fax:
Mailing address:
  • Phone: 626-219-6280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberRCP 9700
License Number StateCA

VIII. Authorized Official

Name: MR. RONALD JAMES WILLIAMS
Title or Position: MANAGER
Credential: RCP
Phone: 626-219-6280