Organization
PENINSULA BIOMEDICAL, INC.
Active
Other names
Peninsula Medical, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNDEE HAFNER (GENERAL MANAGER)
(831) 430-9066
Entity
Organization
Contact information
Practice address
108 WHISPERING PINES DR, SUITE 115, SCOTTS VALLEY, CA 95066-4792
(831) 430-9066
(831) 430-9068
Mailing address
PO BOX 66149, SCOTTS VALLEY, CA 95067-6149
(831) 430-9066
(831) 430-9068
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
2676
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2107491
—
OH
05
—
29401372
—
CO
05
—
4549517
—
MI
05
—
807375000
—
ID
05
—
8129631-00
—
MN
05
—
82712600
—
WI
05
—
9048612
—
WA
05
—
9102475
—
VA
Enumeration date
01/16/2007
Last updated
07/19/2017
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