Healthcare Provider Details

I. General information

NPI: 1740416999
Provider Name (Legal Business Name): MEDICAL DYNAMICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5720 LONETREE BLVD
ROCKLIN CA
95765-3734
US

IV. Provider business mailing address

5720 LONETREE BLVD
ROCKLIN CA
95765-3734
US

V. Phone/Fax

Practice location:
  • Phone: 916-624-3952
  • Fax: 916-624-3954
Mailing address:
  • Phone: 916-624-3952
  • Fax: 916-624-3954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM CARMOUCHE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 916-624-3952