Organization
OCOTILLO PHARMACY, INC.
Active
Other names
Ocotillo Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY GELMAN RPH (OWNER/PRESIDENT)
(760) 554-6940
Entity
Organization
Contact information
Practice address
1501 OCOTILLO DR STE B, EL CENTRO, CA 92243-4217
(760) 352-7100
(760) 337-5979
Mailing address
PO BOX 2100, EL CENTRO, CA 92244-2100
(760) 352-7100
(760) 337-5979
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
45285
CA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
45285
CA
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
45285
CA
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0447810001
MEDICARE
CA
01
—
45285
HMDR
CA
Enumeration date
11/07/2007
Last updated
01/07/2010
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