Organization
B LACED MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEOZENE STONE (MANAGING MEMBER)
(209) 972-0340
Entity
Organization
Contact information
Practice address
1528 SHIRLEY AVE, MANTECA, CA 95337
(209) 972-0340
Mailing address
249 COMMERCE AVE # 1057, MANTECA, CA 95336-5061
(209) 972-0340
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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