Organization
MOUNTAIN CARE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON JOHNSON (DIRECTOR)
(928) 457-2500
Entity
Organization
Contact information
Practice address
91 S MAIN ST STE D, SNOWFLAKE, AZ 85937-5285
(928) 457-2500
(928) 457-0404
Mailing address
91 S MAIN ST STE D, SNOWFLAKE, AZ 85937-5285
(928) 457-2500
(928) 457-0404
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
02/08/2021
Last updated
05/20/2021
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