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General NPI Number Information
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NPI Number | 1417978065
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Entity Type | Organization
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Legal Business Name | LODI SICK ROOM SUPPLY INC
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 340 S FAIRMONT AVE
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City | LODI
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State | CA
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Zip | 95240-3802
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Country | US
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Telephone | 209-369-3641
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Fax | 209-369-4618
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Provider Business Mailing Address
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Address Line | 340 S FAIRMONT AVE
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City | LODI
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State | CA
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Zip | 95240-3802
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Country | US
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Telephone | 209-369-3641
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Fax | 209-369-4618
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUDY CANEPA
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Credential |
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Telephone | 209-369-3641
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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 | ZZZ49755Z
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | ZZZ49755Z
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License Number State | CA
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