Organization
POMONA MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HELLIESEN (CEO)
(909) 623-4378
Entity
Organization
Contact information
Practice address
733 E HOLT AVE, POMONA, CA 91767-5627
(909) 623-4378
(909) 622-2375
Mailing address
733 E HOLT AVE, POMONA, CA 91767-5627
(909) 623-4378
(909) 622-2375
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ31459Z
—
CA
Enumeration date
07/21/2010
Last updated
06/15/2011
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