# MEDPORT RESTORATIVE CARE & REHAB SUPPLIES, INC.

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

## Provider details

- **NPI number:** 1144272261
- **Authorized official:** JOSE M. ROSADO L.V.N., C.O.F. (PRESIDENT, OWNER)
- **Authorized official phone:** (661) 269-5795

## Contact information

- **Practice address:** 1672 W AVENUE J, SUITE \#207-C, LANCASTER, CA 93534-2827
- **Practice address phone:** (661) 945-3344
- **Practice address fax:** (661) 945-1144
- **Mailing address:** PO BOX 8937, LANCASTER, CA 93539-8937
- **Mailing address phone:** (661) 945-3344
- **Mailing address fax:** (661) 945-1144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 47080 | CA | Yes |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 08/22/2020