MEDICARE: AQUION MEDICAL SUPPLIES 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		CA

General Provider Information

NPI Number	:	1982835435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AQUION MEDICAL SUPPLIES INC

Provider Business Mailing Address
First Line	:	2844 AUBURN BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-1805
Country	:	US
Telephone Number	:	916-514-0405
Fax Number	:

Provider Business Practice Location Address
First Line	:	2844 AUBURN BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-1805
Country	:	US
Telephone Number	:	916-514-0405
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SURYA SOLANKI
Credential	:
Telephone Number	:	916-709-5990

Provider Enumeration Date	:	07/31/2009
Last Update Date	:	07/31/2009

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