Organization
MAULIN MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL JAMES MAULIN N/A (PRESIDENT)
(719) 647-2938
Entity
Organization
Contact information
Practice address
486 E GENTRY DR, PUEBLO WEST, CO 81007-3424
(719) 647-2938
Mailing address
486 E. GENTRY DR., PUEBLO WEST,, CO 81007
(719) 647-2938
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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