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General NPI Number Information
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NPI Number | 1821165218
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Entity Type | Organization
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Legal Business Name | BUKATE MEDICAL SUPPLIER
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 5832 W SAN MIGUEL AVE SUITE 3
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City | GLENDALE
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State | AZ
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Zip | 85301-5907
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Country | US
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Telephone | 623-877-1221
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Fax | 623-435-1288
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Provider Business Mailing Address
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Address Line | 5832 W SAN MIGUEL AVE SUITE 3
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City | GLENDALE
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State | AZ
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Zip | 85301-5907
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Country | US
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Telephone | 623-877-1221
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Fax | 623-435-1288
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Authorized Official
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Title or Position | PRESIDENT
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Name | CATHERINE EKEREUKE
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Credential |
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Telephone | 818-645-2969
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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 | AZ
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