Healthcare Provider Details

I. General information

NPI: 1265498760
Provider Name (Legal Business Name): SCHRADERS MEDICAL SUPPLY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5507 BROOKS ST
MONTCLAIR CA
91763-4547
US

IV. Provider business mailing address

5507 BROOKS ST
MONTCLAIR CA
91763-4547
US

V. Phone/Fax

Practice location:
  • Phone: 909-447-7040
  • Fax:
Mailing address:
  • Phone: 909-447-7040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. KRISTINA MARIE MCINTOSH
Title or Position: PRESIDENT
Credential:
Phone: 909-447-7040