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General NPI Number Information
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NPI Number | 1083281422
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Entity Type | Organization
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Legal Business Name | UNITED PATIENT MED SUPPLY LLC
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 2302 E 15TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90021-2861
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Country | US
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Telephone | 916-299-9942
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Fax |
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Provider Business Mailing Address
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Address Line | 39 EMMET AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2719
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHRISTIAN R GAMARRA
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Credential |
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Telephone | 916-299-9942
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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 |
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License Number State |
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