Healthcare Provider Details

I. General information

NPI: 1891244430
Provider Name (Legal Business Name): PRECISIONMEDS SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 E COLORADO BLVD SUITE 202
PASADENA CA
91101-2006
US

IV. Provider business mailing address

638 E COLORADO BLVD SUITE 202
PASADENA CA
91101-2006
US

V. Phone/Fax

Practice location:
  • Phone: 800-209-1203
  • Fax:
Mailing address:
  • Phone: 800-209-1203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number54403
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number54403
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number54403
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number54403
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number54403
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number54403
License Number StateCA

VIII. Authorized Official

Name: MR. JOSEPH RENO
Title or Position: PRESIDENT
Credential:
Phone: 310-437-9209