Organization
CENTRAL VALLEY MEDICAL SUPPORT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL L BALLARD (PRESIDENT)
(209) 823-2337
Entity
Organization
Contact information
Practice address
1434 DEER CREEK CT, MANTECA, CA 95336-9110
(209) 823-2337
Mailing address
PO BOX 2564, MANTECA, CA 95336-1167
(209) 823-2337
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME01780G
—
CA
Enumeration date
09/20/2005
Last updated
08/22/2020
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