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General NPI Number Information
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NPI Number | 1760787188
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Entity Type | Organization
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Legal Business Name | ASSURANCE MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 10574 ACACIA ST STE D1
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5448
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Country | US
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Telephone | 888-865-0936
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Fax | 888-868-2872
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Provider Business Mailing Address
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Address Line | 10574 ACACIA ST STE D1
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5448
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Country | US
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Telephone | 888-865-0936
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Fax | 888-868-2872
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Authorized Official
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Title or Position | CEO
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Name | MRS. KARINA GONZALEZ
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Credential |
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Telephone | 888-865-0936
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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 | 52425
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License Number State | CA
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