Organization
R. A. MEDICAL COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NOBLE FREDERICK WAIDELICH SR. R.R.T. (PARTNER)
(707) 463-0160
Entity
Organization
Contact information
Practice address
407 E PERKINS ST, UKIAH, CA 95482-4506
(707) 463-0160
(707) 463-0532
Mailing address
407 E PERKINS ST, UKIAH, CA 95482-4506
(707) 463-0160
(707) 463-0532
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
CA
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME00294H
—
CA
01
—
ZZZ97844Z
BLUE SHIELD
—
Enumeration date
09/16/2006
Last updated
09/11/2025
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