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General NPI Number Information
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NPI Number | 1962635367
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Entity Type | Organization
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Legal Business Name | WATER FOR YOU INC
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | 9567 ARROW RTE STE L
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4550
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Country | US
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Telephone | 909-987-1661
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Fax | 909-987-1663
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Provider Business Mailing Address
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Address Line | 9567 ARROW RTE STE L
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4550
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Country | US
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Telephone | 909-987-1661
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Fax | 909-987-1663
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. LORRIE ELIZABETH STAU
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Credential |
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Telephone | 909-987-1661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 52469
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License Number State | CA
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