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General NPI Number Information
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NPI Number | 1720664808
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Entity Type | Organization
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Legal Business Name | TECHNOLOGY & MEDICAL STORE INC
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 101 S LA CANADA DR STE 60
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-2665
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Country | US
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Telephone | 520-333-2599
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Fax | 520-800-8781
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Provider Business Mailing Address
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Address Line | 6418 S ACACIA DESERT AVE
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City | TUCSON
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State | AZ
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Zip | 85706-3026
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Country | US
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Telephone | 520-955-0941
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Fax |
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Authorized Official
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Title or Position | FRANCHISE OWNER
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Name | MOSES ANTHONY VALENZUELA
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Credential |
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Telephone | 520-333-2599
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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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