Organization
PREMIER MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN FRANCIS BETTENCOURT (VICE-PRESIDENT)
(209) 537-2882
Entity
Organization
Contact information
Practice address
900 N MARKET BLVD, SUITE H, SACRAMENTO, CA 95834-1264
(916) 646-1600
(916) 646-1616
Mailing address
900 N MARKET BLVD, SUITE H, SACRAMENTO, CA 95834-1264
(916) 646-1600
(916) 646-1616
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
56332
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56332
MEDICAL DEVICE RETAILER
CA
Enumeration date
10/27/2011
Last updated
10/27/2011
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