Organization
PREMIER MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN BETTENCOURT (VICE PRESIDENT)
(209) 537-2882
Entity
Organization
Contact information
Practice address
2800 MITCHELL RD, SUITE F, CERES, CA 95307-9463
(209) 537-2882
(209) 537-0301
Mailing address
2800 MITCHELL RD, SUITE F, CERES, CA 95307-9463
(209) 537-2882
(209) 537-0301
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100215
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME01793F
—
CA
Enumeration date
11/21/2006
Last updated
05/08/2012
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