# HARBOR MEDICAL SUPPLY

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

## Provider details

- **NPI number:** 1720117203
- **Authorized official:** MRS. NELLY MERZHERITSKY (MANAGER)
- **Authorized official phone:** (415) 336-9269

## Contact information

- **Practice address:** 2917 W CAPITOL AVE, WEST SACRAMENTO, CA 95691-2910
- **Practice address phone:** (916) 372-8766
- **Practice address fax:** (916) 372-1750
- **Mailing address:** 2917 W CAPITOL AVE, WEST SACRAMENTO, CA 95691-2910
- **Mailing address phone:** (916) 372-8766
- **Mailing address fax:** (916) 372-1750

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | DME0218OF | CA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 03/02/2007
- **Last updated:** 10/12/2007