Organization
PROMEDICA MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIANN CAROLINA VALENZUELA (CEO)
(619) 621-8162
Entity
Organization
Contact information
Practice address
1446 FRONT ST STE 200, SAN DIEGO, CA 92101-3425
(858) 800-3550
Mailing address
1446 FRONT ST STE 200, SAN DIEGO, CA 92101-3425
(858) 800-3550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
01/24/2024
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