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General NPI Number Information
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NPI Number | 1851093066
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Entity Type | Organization
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Legal Business Name | FED MED INC
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 04/30/2023
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Provider Practice Location Address
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Address Line | 8350 MARTINELLI RD
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City | FORESTVILLE
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State | CA
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Zip | 95436-9713
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Country | US
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Telephone | 707-835-7796
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1461
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City | FORESTVILLE
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State | CA
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Zip | 95436-1461
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Country | US
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Telephone | 707-835-7796
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | CHRIS BOVEY
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Credential |
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Telephone | 707-978-6204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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