MEDICARE: MEDSERVCO, 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	174400000X	Specialist

General Provider Information

NPI Number	:	1982821674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDSERVCO, INC.

Provider Business Mailing Address
First Line	:	4115 BLACKHAWK PLAZA CIR
Second Line	:	SUITE 100
City	:	DANVILLE
State	:	CA
Zip	:	94506-4901
Country	:	US
Telephone Number	:	925-736-7764
Fax Number	:	925-838-2910

Provider Business Practice Location Address
First Line	:	2500 OLD CROW CANYON RD
Second Line	:	SUITE 216
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1623
Country	:	US
Telephone Number	:	925-736-7764
Fax Number	:	925-838-2910

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RICHARD REED
Credential	:
Telephone Number	:	925-736-7764

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	08/22/2020

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