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General NPI Number Information
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NPI Number | 1376093567
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Entity Type | Organization
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Legal Business Name | MY HOME MEDICAL SUPPLIES
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 4700 NORTHGATE BLVD STE 160
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City | SACRAMENTO
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State | CA
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Zip | 95834-1147
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Country | US
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Telephone | 916-921-1054
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Fax | 916-943-1633
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Provider Business Mailing Address
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Address Line | 4700 NORTHGATE BLVD STE 160
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City | SACRAMENTO
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State | CA
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Zip | 95834-1147
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Country | US
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Telephone | 916-921-1054
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Fax | 916-943-1633
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Authorized Official
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Title or Position | MANAGER
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Name | CHERYL MARTINEZ
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Credential |
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Telephone | 916-921-1054
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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 | 76536
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License Number State | CA
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