# SAN JOAQUIN MEDICAL SUPPLY INC

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

## Provider details

- **NPI number:** 1346787108
- **Authorized official:** MANUEL DIAGO (PRESIDENT)
- **Authorized official phone:** (559) 334-8790

## Contact information

- **Practice address:** 10810 AVENUE 184, TULARE, CA 93274-9514
- **Practice address phone:** (559) 334-8790
- **Mailing address:** 10810 AVENUE 184, TULARE, CA 93274-9514
- **Mailing address phone:** (559) 334-8790

## Taxonomy

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

## Other

- **Enumeration date:** 01/31/2017
- **Last updated:** 01/31/2017