MEDICARE: D&M MEDICAL SUPPLY, LLC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1194245241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D&M MEDICAL SUPPLY, LLC

Provider Business Mailing Address
First Line	:	13321 ALONDRA BLVD STE I
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-7016
Country	:	US
Telephone Number	:	562-474-8311
Fax Number	:	562-474-8321

Provider Business Practice Location Address
First Line	:	13321 ALONDRA BLVD STE I
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-7016
Country	:	US
Telephone Number	:	562-474-8311
Fax Number	:	562-474-8321

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	RODELIA CUNANAN
Credential	:
Telephone Number	:	562-474-8311

Provider Enumeration Date	:	06/20/2017
Last Update Date	:	07/18/2023

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