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General NPI Number Information
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NPI Number | 1972006906
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Entity Type | Organization
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Legal Business Name | THE BETTY MILLS COMPANY, INC.
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Dates
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Enumeration Date | 03/15/2018
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Last Update Date | 03/15/2018
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Provider Practice Location Address
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Address Line | 161 W 25TH AVE STE 203
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City | SAN MATEO
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State | CA
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Zip | 94403-2269
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Country | US
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Telephone | 650-645-6260
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Fax |
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Provider Business Mailing Address
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Address Line | 161 W 25TH AVE STE 203
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City | SAN MATEO
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State | CA
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Zip | 94403-2269
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Country | US
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Telephone | 650-645-6260
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VICTOR HANNA
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Credential |
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Telephone | 650-645-6260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number | 96157
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License Number State | CA
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