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Organization
VISTA GRANDE MEDICAL SUPPLIES, INC.
Active
Organization
VISTA GRANDE MEDICAL SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BROWN (OWNER)
(619) 750-5627
Entity
Organization
Contact information
Practice address
3435 CAMINO DEL RIO S STE 204, SAN DIEGO, CA 92108-3911
(619) 750-5627
Mailing address
3435 CAMINO DEL RIO S STE 204, SAN DIEGO, CA 92108-3911
(619) 750-5627
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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