Organization
SAN JOSE MEDICAL SUPPLY CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA SANTA ANA (ADMINISTRATIVE ASSISTANT)
(408) 573-7200
Entity
Organization
Contact information
Practice address
283 EAST BROKAW ROAD, SAN JOSE, CA 95112
(408) 573-7200
Mailing address
283 EAST BROKAW ROAD, SAN JOSE, CA 95112
(408) 573-7200
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100890
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME01174F
—
CA
Enumeration date
11/09/2006
Last updated
05/22/2013
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