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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