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General NPI Number Information
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NPI Number | 1508007170
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Entity Type | Organization
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Legal Business Name | FRONT MEDICAL SUPPLIES INC
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 316 FRONT ST SUITE 202
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City | EL CAJON
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State | CA
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Zip | 92020-4252
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Country | US
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Telephone | 888-820-5880
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Fax | 619-401-6913
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Provider Business Mailing Address
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Address Line | 316 FRONT ST SUITE 202
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City | EL CAJON
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State | CA
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Zip | 92020-4252
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Country | US
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Telephone | 888-820-5880
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Fax | 619-401-6913
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Authorized Official
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Title or Position | PRESIDENT
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Name | WISSAM GIBO
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Credential |
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Telephone | 888-820-5880
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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 | 50851
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License Number State | CA
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