Organization
ELK GROVE MEDICAL & DENTAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DAVIES ONONIWU (OWNER)
(916) 691-4200
Entity
Organization
Contact information
Practice address
8139 ELK GROVE BLVD, SUITE 155, ELK GROVE, CA 95758-5519
(916) 691-4200
(916) 691-4245
Mailing address
8139 ELK GROVE BLVD, SUITE 155, ELK GROVE, CA 95758-5519
(916) 691-4200
(916) 691-4245
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5395690001
CA
Other
Enumeration date
06/24/2006
Last updated
08/22/2020
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