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General NPI Number Information
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NPI Number | 1538414743
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Entity Type | Organization
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Legal Business Name | MERIDIAN MEDICAL RESOURCES, INC.
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Dates
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Enumeration Date | 07/13/2012
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 740 W MILL ST UNITS G & H
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City | SAN BERNARDINO
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State | CA
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Zip | 92410-3359
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Country | US
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Telephone | 800-320-4259
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Fax | 800-320-4287
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Provider Business Mailing Address
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Address Line | PO BOX 2040
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City | SAN BERNARDINO
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State | CA
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Zip | 92406-2040
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Country | US
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Telephone | 800-320-4259
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Fax | 800-320-4287
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MR. FERMIN ALEXANDER IGLESIAS
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Credential |
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Telephone | 818-381-2464
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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 | 56288
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License Number State | CA
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