Organization
DIVINE MEDICAL SUPPLIES, INC
Active
Organization
DIVINE MEDICAL SUPPLIES, INC
Active
Other names
Divine Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FEMI ABATAN (PRESIDENT)
(714) 225-4762
Entity
Organization
Contact information
Practice address
7070 UPPER 157TH ST W, APPLE VALLEY, MN 55124-5121
(714) 225-4762
(714) 930-9435
Mailing address
7070 UPPER 157TH ST W, APPLE VALLEY, MN 55124-5121
(714) 225-4762
(714) 930-9435
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
07/13/2011
Last updated
07/13/2011
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