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General NPI Number Information
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NPI Number | 1487757423
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Entity Type | Organization
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Legal Business Name | PRIDE MEDICAL SUPPLIES
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 303 MILLER RD #2019
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City | SCOTTSDALE
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State | AZ
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Zip | 58257
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Country | US
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Telephone | 818-207-1449
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Fax |
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Provider Business Mailing Address
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Address Line | 7620 E MC KELLIPS RD. #9
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City | SCOTTSDALE
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State | AZ
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Zip | 58257
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Country | US
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Telephone | 480-874-5831
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Fax | 480-874-4839
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Authorized Official
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Title or Position | OWNER
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Name | MR. VALENTIN MUNTEANU
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Credential |
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Telephone | 480-874-5831
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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 | 20127464
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License Number State | AZ
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