Organization
RAE MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA RAE LORDEN RN (CEO)
(916) 715-4317
Entity
Organization
Contact information
Practice address
6454 PONY EXPRESS TRL, SUITE 33, POLLOCK PINES, CA 95726-9652
(916) 715-4317
Mailing address
PO BOX 1343, PLACERVILLE, CA 95667-1343
(916) 715-4317
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
047113
CA
332BC3200X
Customized Equipment (DME)
047113
CA
332BN1400X
Nursing Facility Supplies (DME)
047113
CA
332BX2000X
Oxygen Equipment & Supplies (DME)
047113
CA
Other
Enumeration date
02/15/2011
Last updated
02/15/2011
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