MEDICARE: DEL RIO MEDICAL INC

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	:	1306306279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEL RIO MEDICAL INC

Provider Business Mailing Address
First Line	:	2727 CAMINO DEL RIO S STE 137D
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3739
Country	:	US
Telephone Number	:	619-314-4228
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 CAMINO DEL RIO S STE 137D
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3739
Country	:	US
Telephone Number	:	619-314-4228
Fax Number	:	844-288-8144

Authorized Official
Title or Position	:	OWNER / CEO
Name	:	ELAINE R MILLER
Credential	:
Telephone Number	:	619-314-4228

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	03/25/2019

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Directions to “DEL RIO MEDICAL INC ” Practice Location

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