Healthcare Provider Details

I. General information

NPI: 1770155376
Provider Name (Legal Business Name): RESHAPE EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 LA PLAYA DR STE 210
HAYWARD CA
94545-2142
US

IV. Provider business mailing address

1090 LA PLAYA DR STE 210
HAYWARD CA
94545-2142
US

V. Phone/Fax

Practice location:
  • Phone: 510-670-4765
  • Fax: 833-748-0122
Mailing address:
  • Phone: 510-670-4765
  • Fax: 833-748-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. ZIAULHAQUE HAMIDI
Title or Position: OWNER
Credential:
Phone: 510-670-4765