Organization
LIVE WELL MEDICAL SUPPLIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN KIETH SIRKO (PRESIDENT/CEO)
(951) 656-3700
Entity
Organization
Contact information
Practice address
7338 SYCAMORE CANYON BLVD, SUITE 1, RIVERSIDE, CA 92508-2334
(951) 656-3700
(951) 697-5866
Mailing address
7338 SYCAMORE CANYON BLVD, SUITE 1, RIVERSIDE, CA 92508-2334
(951) 656-3700
(951) 697-5866
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
1230445
CA
Other
Enumeration date
12/29/2014
Last updated
12/29/2014
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