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Organization
MEDSUPPLY
Active
Organization
MEDSUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM J FRERICHS (PRESIDENT)
(559) 292-1540
Entity
Organization
Contact information
Practice address
5105 E DAKOTA AVE STE 102, FRESNO, CA 93727-7443
(559) 292-1540
(559) 292-1539
Mailing address
5105 E DAKOTA AVE STE 102, FRESNO, CA 93727-7443
(559) 292-1540
(559) 292-1539
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
43583
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43583
CA HOME MEDICAL DEVICE
CA
05
—
DME03428F
—
CA
Enumeration date
01/22/2007
Last updated
09/22/2020
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