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Organization
RIALTO MEDICAL SUPPLIES, INC.
Active
Organization
RIALTO MEDICAL SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS ALAN COOPER (PRESIDENT)
(909) 744-8067
Entity
Organization
Contact information
Practice address
26598 PINE AVE., RIMFOREST, CA 92378
(909) 744-8067
Mailing address
PO BOX 583, LAKE ARROWHEAD, CA 92352-0583
(909) 744-8067
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
101217
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ77264Z
—
CA
Enumeration date
08/03/2006
Last updated
06/27/2012
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