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General NPI Number Information
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NPI Number | 1619828902
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Entity Type | Organization
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Legal Business Name | INNOVAMED INDUSTRIES LLC
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 38340 INNOVATION CT # D-403
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City | MURRIETA
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State | CA
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Zip | 92563-2621
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Country | US
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Telephone | 951-521-2839
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Fax |
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Provider Business Mailing Address
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Address Line | 38340 INNOVATION CT # D-403
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City | MURRIETA
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State | CA
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Zip | 92563-2621
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Country | US
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Telephone | 951-521-2839
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE MARKETING
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Name | MR. ROMEO REYES LADERO JR.
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Credential | NP
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Telephone | 951-521-2839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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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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