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General NPI Number Information
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NPI Number | 1093890246
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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 | 10/26/2006
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 102 S EL CAMINO REAL
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City | SAN MATEO
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State | CA
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Zip | 94401-3810
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Country | US
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Telephone | 650-348-2207
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Fax | 650-348-1821
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Provider Business Mailing Address
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Address Line | 102 S EL CAMINO REAL
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City | SAN MATEO
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State | CA
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Zip | 94401-3810
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Country | US
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Telephone | 650-348-2207
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Fax | 650-348-1821
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Authorized Official
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Title or Position | OWNER
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Name | DMITRY MELNIKOV
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Credential |
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Telephone | 650-348-2207
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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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