Organization
ON THE GO MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANA NAWAZ (OWNER)
(760) 552-4075
Entity
Organization
Contact information
Practice address
12421 HESPERIA RD STE 1, VICTORVILLE, CA 92395-7704
(760) 552-4075
(760) 552-4023
Mailing address
12421 HESPERIA RD STE 1, VICTORVILLE, CA 92395-7704
(760) 552-4075
(760) 552-4023
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
98950
CA
332BX2000X
Oxygen Equipment & Supplies (DME)
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Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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