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General NPI Number Information
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NPI Number | 1912138256
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Entity Type | Organization
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Legal Business Name | MEDI-LE MEDICAL SUPPLIES, INC
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 7811 LAGUNA BLVD STE 180
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City | ELK GROVE
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State | CA
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Zip | 95758-7949
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Country | US
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Telephone | 916-478-2634
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Fax | 916-478-2563
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Provider Business Mailing Address
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Address Line | 7811 LAGUNA BLVD STE 180
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City | ELK GROVE
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State | CA
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Zip | 95758-7949
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Country | US
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Telephone | 916-478-2634
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Fax | 916-478-2563
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Authorized Official
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Title or Position | OWNER
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Name | DIEM T NGUYEN
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Credential | DC
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Telephone | 916-478-2634
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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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