Organization
DESERT MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN L BEAUDOIN (MANAGING MEMBER)
(480) 495-3537
Entity
Organization
Contact information
Practice address
43491 N FRIEND AVE, QUEEN CREEK, AZ 85242-9621
(480) 987-4181
(800) 681-0684
Mailing address
43491 N FRIEND AVE, QUEEN CREEK, AZ 85242-9621
(480) 987-4181
(800) 681-0684
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20176791
STATE RESALE TAX NUMBER
AZ
Enumeration date
06/27/2007
Last updated
07/14/2007
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