# NORCAL MEDICAL SUPPLY, INC

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

## Provider details

- **NPI number:** 1669949707
- **Authorized official:** MS. SHERIAN LEA PRINCE (SHAREHOLDER)
- **Authorized official phone:** (707) 769-9606

## Contact information

- **Practice address:** 620 PETALUMA BLVD N STE A, PETALUMA, CA 94952-2870
- **Practice address phone:** (707) 769-9606
- **Practice address fax:** (707) 776-4659
- **Mailing address:** PO BOX 4495, PETALUMA, CA 94955-4495
- **Mailing address phone:** (707) 769-9606
- **Mailing address fax:** (707) 776-4659

## Taxonomy

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

## Other

- **Enumeration date:** 10/26/2018
- **Last updated:** 10/26/2018