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General NPI Number Information
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NPI Number | 1598896540
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Entity Type | Organization
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Legal Business Name | PRIMECARE MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 12146 SOUTH ST SUITE F
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City | ARTESIA
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State | CA
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Zip | 90701-6844
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Country | US
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Telephone | 562-860-4813
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Fax | 562-860-4823
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Provider Business Mailing Address
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Address Line | 12146 SOUTH ST SUITE F
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City | ARTESIA
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State | CA
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Zip | 90701-6844
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Country | US
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Telephone | 562-860-4813
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Fax | 562-860-4823
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Authorized Official
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Title or Position | PRESIDENT
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Name | DELE SILVIA
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Credential |
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Telephone | 562-860-4813
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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 | 46022
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License Number State | CA
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