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General NPI Number Information
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NPI Number | 1740740257
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Entity Type | Organization
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Legal Business Name | SWEETWATER MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 124 E 30TH ST STE A4
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City | NATIONAL CITY
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State | CA
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Zip | 91950-7332
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Country | US
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Telephone | 619-937-3990
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Fax | 619-383-2300
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Provider Business Mailing Address
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Address Line | 124 E 30TH ST STE A4
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City | NATIONAL CITY
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State | CA
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Zip | 91950-7332
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Country | US
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Telephone | 619-937-3990
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Fax | 619-383-2300
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARAMIS RAFAEL VELA
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Credential |
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Telephone | 619-937-3990
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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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