# PENINSULA BIOMEDICAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peninsula Medical, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386795011
- **Authorized official:** MRS. ANNDEE HAFNER (GENERAL MANAGER)
- **Authorized official phone:** (831) 430-9066

## Contact information

- **Practice address:** 108 WHISPERING PINES DR, SUITE 115, SCOTTS VALLEY, CA 95066-4792
- **Practice address phone:** (831) 430-9066
- **Practice address fax:** (831) 430-9068
- **Mailing address:** PO BOX 66149, SCOTTS VALLEY, CA 95067-6149
- **Mailing address phone:** (831) 430-9066
- **Mailing address fax:** (831) 430-9068

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BC3200X | Customized Equipment (DME) | 2676 | CA | — |

## Other

- **Enumeration date:** 01/16/2007
- **Last updated:** 07/19/2017