Healthcare Provider Details

I. General information

NPI: 1942112461
Provider Name (Legal Business Name): PARACELSUS MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 IRON POINT RD APT 711
FOLSOM CA
95630-8493
US

IV. Provider business mailing address

2300 IRON POINT RD APT 711
FOLSOM CA
95630-8493
US

V. Phone/Fax

Practice location:
  • Phone: 916-862-5414
  • Fax:
Mailing address:
  • Phone: 916-862-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: RODRIGO AGNES OBEDOZA
Title or Position: MANAGER
Credential:
Phone: 916-862-5414