Organization
FRONTIER MEDICAL DISTRIBUTORS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BONIFICACIO RUIZ (CEO)
(956) 489-9368
Entity
Organization
Contact information
Practice address
4610 SAN BERNARDO AVE STE 3C, LAREDO, TX 78041-5720
(956) 608-3075
(956) 608-3076
Mailing address
4610 SAN BERNARDO AVE STE 3C, LAREDO, TX 78041-5720
(956) 608-3075
(956) 608-3076
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/10/2018
Last updated
10/29/2018
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