Organization
WATERMAN MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SERGEY IVANOV (CEO)
(909) 383-7284
Entity
Organization
Contact information
Practice address
1364 N WATERMAN AVE, # 105, SAN BERNARDINO, CA 92404-5313
(909) 383-7284
(909) 383-5433
Mailing address
1364 N WATERMAN AVE, # 105, SAN BERNARDINO, CA 92404-5313
(909) 383-7284
(909) 383-5433
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
51274
CA
Other
Enumeration date
04/28/2009
Last updated
05/21/2009
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