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Organization
PACIFIC MEDICAL SUPPLY
Active
Organization
PACIFIC MEDICAL SUPPLY
Active
Other names
Pacific Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FIDELIS GABRIEL EKONG (OWNER)
(951) 552-0322
Entity
Organization
Contact information
Practice address
574 CALHOUN ST, CORONA, CA 92879-5846
(951) 553-0322
(951) 279-6004
Mailing address
574 CALHOUN ST, CORONA, CA 92879-5846
(951) 553-0322
(951) 279-6004
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
09/27/2006
Last updated
08/22/2020
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