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General NPI Number Information
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NPI Number | 1285092585
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Entity Type | Organization
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Legal Business Name | JW DURABLE MECICAL EQUIPMENT
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Dates
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Enumeration Date | 02/02/2016
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 343 E ALVARADO ST STE A
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City | FALLBROOK
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State | CA
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Zip | 92028-2966
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Country | US
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Telephone | 760-473-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 343 ALVARADO ST STE A
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City | FALLBROK
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State | CA
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Zip | 92028-2966
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Country | US
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Telephone | 760-473-4343
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD CLEMENTS
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Credential |
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Telephone | 760-473-4343
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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 | CA
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