Healthcare Provider Details

I. General information

NPI: 1679392542
Provider Name (Legal Business Name): AZERRI, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4274 N BLACKSTONE AVE STE 106
FRESNO CA
93726-1900
US

IV. Provider business mailing address

4274 N BLACKSTONE AVE STE 106
FRESNO CA
93726-1900
US

V. Phone/Fax

Practice location:
  • Phone: 800-666-5323
  • Fax:
Mailing address:
  • Phone: 800-666-5323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. ROXANNE VALDEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 800-666-5323