MEDICARE: BRANIK 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
1	332B00000X	Durable Medical Equipment & Medical Supplies	5656810001	CA

General Provider Information

NPI Number	:	1699701748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANIK MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	3453 RAMONA AVE
Second Line	:	SUITE 11
City	:	SACRAMENTO
State	:	CA
Zip	:	95826-3828
Country	:	US
Telephone Number	:	916-737-0300
Fax Number	:	916-737-1923

Provider Business Practice Location Address
First Line	:	3453 RAMONA AVE
Second Line	:	SUITE 11
City	:	SACRAMENTO
State	:	CA
Zip	:	95826-3828
Country	:	US
Telephone Number	:	916-737-0300
Fax Number	:	916-737-1923

Authorized Official
Title or Position	:	OWNER
Name	:	MR. OZOREMEZINEM T NWAOBI
Credential	:
Telephone Number	:	916-737-0300

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	08/22/2020

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