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General NPI Number Information
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NPI Number | 1083128102
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Entity Type | Organization
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Legal Business Name | NEW LIFE MEDICAL SUPPLIES, LLC
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 925 B ST STE 304
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City | SAN DIEGO
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State | CA
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Zip | 92101-4628
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Country | US
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Telephone | 800-903-6171
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Fax | 800-903-7116
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Provider Business Mailing Address
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Address Line | 925 B ST STE 304
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City | SAN DIEGO
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State | CA
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Zip | 92101-4628
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Country | US
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Telephone | 800-903-6171
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Fax | 800-903-7116
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Authorized Official
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Title or Position | OWNER / GM
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Name | MR. JOHN MICHAEL SILVA
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Credential |
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Telephone | 858-663-8035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 97340
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License Number State | CA
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