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General NPI Number Information
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NPI Number | 1730025784
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Entity Type | Organization
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Legal Business Name | SACRAMENTO MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 1968 FULTON AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-1906
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Country | US
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Telephone | 916-212-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 1968 FULTON AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-1906
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Country | US
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Telephone | 916-212-2323
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | JOHNNIE B NOLEN
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Credential |
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Telephone | 916-212-2323
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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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