# ELK GROVE MEDICAL SUPPLIES, INC

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

## Provider details

- **NPI number:** 1316251937
- **Authorized official:** MS. ANDREA K KONO (OWNER)
- **Authorized official phone:** (916) 686-9595

## Contact information

- **Practice address:** 8949 ELK GROVE BLVD, ELK GROVE, CA 95624-1942
- **Practice address phone:** (916) 686-9595
- **Practice address fax:** (916) 686-9596
- **Mailing address:** 8949 ELK GROVE BLVD, ELK GROVE, CA 95624-1942
- **Mailing address phone:** (916) 686-9595
- **Mailing address fax:** (916) 686-9596

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 52828 | CA | Yes |

## Other

- **Enumeration date:** 08/06/2010
- **Last updated:** 08/06/2010