Organization
DURABLE MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEZMEN M HEWITT (AUTHORIZED OFFICIAL)
(928) 302-3140
Entity
Organization
Contact information
Practice address
344 LONDON BRIDGE RD STE F, LAKE HAVASU CITY, AZ 86403-4619
(928) 302-3140
(928) 302-3139
Mailing address
344 LONDON BRIDGE RD STE F, LAKE HAVASU CITY, AZ 86403-4619
(928) 302-3140
(928) 302-3139
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/14/2020
Last updated
05/29/2020
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