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General NPI Number Information
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NPI Number | 1710038799
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Entity Type | Organization
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Legal Business Name | KERRY'S MEDICAL INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5605 W NORTHERN AVE
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City | GLENDALE
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State | AZ
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Zip | 85301-1332
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Country | US
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Telephone | 623-931-3434
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Fax | 623-931-3535
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Provider Business Mailing Address
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Address Line | 2204 W CAPITOL AVE
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City | W SACRAMENTO
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State | CA
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Zip | 95691-2425
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Country | US
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Telephone | 916-374-0400
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Fax | 916-374-0404
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. TIMOTHY LANE MILBERGER
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Credential |
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Telephone | 916-374-0400
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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 |
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License Number State |
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