Healthcare Provider Details

I. General information

NPI: 1194807297
Provider Name (Legal Business Name): AIDS FOR DAILY LIVING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 SUNSET BLVD SUITE #140
ROCKLIN CA
95765-3770
US

IV. Provider business mailing address

1140 SUNSET BLVD SUITE #140
ROCKLIN CA
95765-3770
US

V. Phone/Fax

Practice location:
  • Phone: 916-624-0900
  • Fax: 916-624-9801
Mailing address:
  • Phone: 916-624-0900
  • Fax: 916-624-9801

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 TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHRISTINE MARIE PEREIRA
Title or Position: PRESIDENT
Credential:
Phone: 916-624-0900