# ON THE GO MEDICAL SUPPLY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134614274
- **Authorized official:** ADRIANA NAWAZ (OWNER)
- **Authorized official phone:** (760) 552-4075

## Contact information

- **Practice address:** 12421 HESPERIA RD STE 1, VICTORVILLE, CA 92395-7704
- **Practice address phone:** (760) 552-4075
- **Practice address fax:** (760) 552-4023
- **Mailing address:** 12421 HESPERIA RD STE 1, VICTORVILLE, CA 92395-7704
- **Mailing address phone:** (760) 552-4075
- **Mailing address fax:** (760) 552-4023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 98950 | CA | Yes |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | — |

## Other

- **Enumeration date:** 06/29/2018
- **Last updated:** 06/29/2018