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NPI Code Detail

MEDICARE: 24HR MEDICAL SUPPLY

MEDICARE: 24HR MEDICAL SUPPLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies00030975CA

General Provider Information

NPI Number : 1164793915
Entity Type Code : Organization
Provider Name (Legal Business Name) : 24HR MEDICAL SUPPLY
Provider Business Mailing Address
First Line : 1036 ARENA CIR
Second Line :
City : VISTA
State : CA
Zip : 92083-3177
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1036 ARENA CIR
Second Line :
City : VISTA
State : CA
Zip : 92083-3177
Country : US
Telephone Number : 760-201-6564
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MARISA LYN MAYLE
Credential :
Telephone Number : 760-201-6564
Provider Enumeration Date : 01/24/2012
Last Update Date : 01/24/2012

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Directions to “24HR MEDICAL SUPPLY ” Practice Location

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