Organization
PACIFIC DURABLE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHAN WILLIAMS (PRESIDENT)
(602) 267-4871
Entity
Organization
Contact information
Practice address
2441 E MADISON ST, PHOENIX, AZ 85034-2638
(602) 267-4871
(480) 302-5287
Mailing address
970 E BROADWAY, E #374, JACKSON, WY 83002
(602) 267-4871
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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