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General NPI Number Information
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NPI Number | 1912131657
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Entity Type | Organization
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Legal Business Name | CT MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 1005 PARKER AVE
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City | TRACY
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State | CA
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Zip | 95376-3933
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Country | US
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Telephone | 209-221-0556
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Fax | 209-221-0456
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Provider Business Mailing Address
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Address Line | 1005 PARKER AVE
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City | TRACY
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State | CA
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Zip | 95376-3933
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Country | US
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Telephone | 209-221-0556
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Fax | 209-221-0456
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANAYO NWANKWO
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Credential |
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Telephone | 209-221-0556
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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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