# B LACED MEDICAL SUPPLY LLC

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

## Provider details

- **NPI number:** 1770433898
- **Authorized official:** DEOZENE STONE (MANAGING MEMBER)
- **Authorized official phone:** (209) 972-0340

## Contact information

- **Practice address:** 1528 SHIRLEY AVE, MANTECA, CA 95337
- **Practice address phone:** (209) 972-0340
- **Mailing address:** 249 COMMERCE AVE \# 1057, MANTECA, CA 95336-5061
- **Mailing address phone:** (209) 972-0340

## Taxonomy

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

## Other

- **Enumeration date:** 01/29/2026
- **Last updated:** 01/29/2026