Healthcare Provider Details

I. General information

NPI: 1508094301
Provider Name (Legal Business Name): ALL UNIVERSAL MEDICAL SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 UNIVERSITY AVE # B
RIVERSIDE CA
92507-4458
US

IV. Provider business mailing address

1617 UNIVERSITY AVE # B
RIVERSIDE CA
92507-4458
US

V. Phone/Fax

Practice location:
  • Phone: 951-684-6161
  • Fax: 951-684-6262
Mailing address:
  • Phone: 951-684-6161
  • Fax: 951-684-6262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberBL00136169
License Number StateCA

VIII. Authorized Official

Name: MR. IRDIA RAJ DESAI
Title or Position: OWNER
Credential:
Phone: 951-684-6161