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General NPI Number Information
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NPI Number | 1457500456
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Entity Type | Organization
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Legal Business Name | CENTRAL VALLEY MEDICAL SUPPLY
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 245 W PACHECO BLVD SUITE C
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City | LOS BANOS
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State | CA
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Zip | 93635-4067
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Country | US
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Telephone | 209-826-4810
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Fax | 209-826-7376
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Provider Business Mailing Address
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Address Line | 245 W PACHECO BLVD SUITE C
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City | LOS BANOS
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State | CA
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Zip | 93635-4067
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Country | US
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Telephone | 209-826-4810
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Fax | 209-826-7376
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Authorized Official
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Title or Position | PARTNER
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Name | MR. ANTHONY SAUL CALDERA
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Credential | REHAB TECHNOLOGY SUP
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Telephone | 209-826-4810
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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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