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General NPI Number Information
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NPI Number | 1275559825
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Entity Type | Organization
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Legal Business Name | LIFE ALERT HOMECARE SUPPLIES, INC.
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 320 N E ST SUITE 100
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City | SAN BERNARDINO
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State | CA
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Zip | 92401-1540
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Country | US
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Telephone | 909-384-1910
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Fax | 909-384-1908
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Provider Business Mailing Address
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Address Line | 320 N E ST SUITE 100
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City | SAN BERNARDINO
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State | CA
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Zip | 92401-1540
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Country | US
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Telephone | 909-384-1910
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Fax | 909-384-1908
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANIETIE JOHN OFFONG
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Credential |
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Telephone | 909-384-1910
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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 | 44974
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License Number State | CA
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