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General NPI Number Information
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NPI Number | 1063710986
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Entity Type | Organization
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Legal Business Name | M & M MEDICAL SUPPLIES, INC.
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Dates
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Enumeration Date | 03/01/2011
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 180 S SPRUCE AVE STE D
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-4558
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Country | US
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Telephone | 650-758-1320
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Fax | 650-758-1390
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Provider Business Mailing Address
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Address Line | 180 S SPRUCE AVE STE D
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-4558
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Country | US
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Telephone | 650-758-1320
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Fax | 650-758-1390
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARKADY MASARSKY
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Credential |
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Telephone | 650-758-1320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 55142
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License Number State | CA
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