Organization
SIERRA-PACIFIC TECHNOLOGY, INC.
Active
Other names
Sierra-Pacific Health Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. UKPONG UWEH (PRESIDENT)
(209) 472-1136
Entity
Organization
Contact information
Practice address
4873 WEST LN, SUITE C, STOCKTON, CA 95210-4548
(209) 472-1136
(209) 472-1138
Mailing address
P.O. BOX 77843, STOCKTON, CA 95267-1143
(209) 472-1136
(209) 472-1138
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
54805
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME02917F
—
CA
Enumeration date
09/08/2010
Last updated
01/27/2011
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