# SACRAMENTO MEDICAL SUPPLY LLC

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

## Provider details

- **NPI number:** 1730025784
- **Authorized official:** JOHNNIE B NOLEN (CEO/OWNER)
- **Authorized official phone:** (916) 212-2323

## Contact information

- **Practice address:** 1968 FULTON AVE, SACRAMENTO, CA 95825-1906
- **Practice address phone:** (916) 212-2323
- **Mailing address:** 1968 FULTON AVE, SACRAMENTO, CA 95825-1906
- **Mailing address phone:** (916) 212-2323

## Taxonomy

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

## Other

- **Enumeration date:** 04/23/2026
- **Last updated:** 04/24/2026