Healthcare Provider Details

I. General information

NPI: 1376300061
Provider Name (Legal Business Name): MORI MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 02/29/2024
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N BUTLER AVE STE 105
FARMINGTON NM
87401-6867
US

IV. Provider business mailing address

2320 LA MIRADA DR
VISTA CA
92081-7862
US

V. Phone/Fax

Practice location:
  • Phone: 760-659-4200
  • Fax: 760-659-4200
Mailing address:
  • Phone: 760-659-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: GORDON MORI
Title or Position: PRESIDENT/CEO
Credential:
Phone: 760-659-4200