Organization
ENTECH MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA HOFFSTETTER (CEO)
(909) 596-6785
Entity
Organization
Contact information
Practice address
1910 D ST, LA VERNE, CA 91750-5410
(909) 596-6785
(909) 596-0052
Mailing address
1910 D ST, LA VERNE, CA 91750-5410
(909) 596-6785
(909) 596-0052
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808842
—
AZ
05
—
DME00666G
—
CA
Enumeration date
06/24/2006
Last updated
08/22/2020
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