Organization
SPECIALTY MEDICAL
Active
Other names
specialty medical
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG D SULLIVAN (OWNER)
(626) 688-5326
Entity
Organization
Contact information
Practice address
2680 POMONA BLVD STE B, POMONA, CA 91768-3272
(626) 688-5326
(626) 599-2025
Mailing address
2680 POMONA BLVD STE B, POMONA, CA 91768-3272
(626) 688-5326
(800) 619-6826
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
25251
CA
3336C0003X
Community/Retail Pharmacy
PHY42098
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA420980
—
CA
Enumeration date
11/16/2007
Last updated
11/25/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up