Organization
IDAMED INC
Active
Other names
AT HOME MEDICAL EQUIPMENT & SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY KRANTZ (PRESIDENT)
(714) 556-4663
Entity
Organization
Contact information
Practice address
17660 NEWHOPE ST, SUITE F, FOUNTAIN VALLEY, CA 92708-4296
(714) 556-4663
(714) 556-4664
Mailing address
17660 NEWHOPE ST, SUITE F, FOUNTAIN VALLEY, CA 92708-4296
(714) 556-4663
(714) 556-4664
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255668786
—
CA
Enumeration date
11/04/2009
Last updated
06/09/2014
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