Organization
GREAT SIMOD MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER A. OGINNI (PRESIDENT)
(916) 977-0512
Entity
Organization
Contact information
Practice address
3400 WATT AVE, SUITE 101, SACRAMENTO, CA 95821-3602
(916) 977-0512
(916) 977-0505
Mailing address
PO BOX 214913, SACRAMENTO, CA 95821-0913
(916) 977-0512
(916) 977-0505
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
52595
CA
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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