Organization
HARBOR MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NELLY MERZHERITSKY (MANAGER)
(415) 336-9269
Entity
Organization
Contact information
Practice address
2917 W CAPITOL AVE, WEST SACRAMENTO, CA 95691-2910
(916) 372-8766
(916) 372-1750
Mailing address
2917 W CAPITOL AVE, WEST SACRAMENTO, CA 95691-2910
(916) 372-8766
(916) 372-1750
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DME0218OF
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME02180F
—
CA
Enumeration date
03/02/2007
Last updated
10/12/2007
Update your record
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