Healthcare Provider Details

I. General information

NPI: 1578730545
Provider Name (Legal Business Name): OROSI MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12579 AVENUE 416
OROSI CA
93647-2056
US

IV. Provider business mailing address

12579 AVENUE 416
OROSI CA
93647-2056
US

V. Phone/Fax

Practice location:
  • Phone: 559-528-9181
  • Fax: 559-528-9181
Mailing address:
  • Phone: 559-528-9181
  • Fax: 559-528-9181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberKHO 101-077577
License Number StateCA

VIII. Authorized Official

Name: EDUARDA BLANEY
Title or Position: PRESEDENT
Credential:
Phone: 559-528-9181