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General NPI Number Information
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NPI Number | 1750826889
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Entity Type | Organization
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Legal Business Name | NATIONWIDE MEDICAL, INC
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Dates
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Enumeration Date | 12/28/2016
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Last Update Date | 12/28/2016
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Provider Practice Location Address
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Address Line | 5150 N UNION BLVD SUITE 103 A
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-2075
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Country | US
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Telephone | 719-594-2024
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Fax |
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Provider Business Mailing Address
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Address Line | 29901 AGOURA RD
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City | AGOURA HILLS
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State | CA
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Zip | 91301-2513
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Country | US
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Telephone | 818-338-3500
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID SIEGEL
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Credential |
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Telephone | 818-338-3500
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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 | 20166001302
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License Number State | CO
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