Organization
HIGH DESERT MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE MARIE SMITH (OWNER)
(541) 447-4688
Entity
Organization
Contact information
Practice address
1251 NE ELM ST STE 1B, PRINEVILLE, OR 97754-3143
(541) 447-4688
(541) 447-1243
Mailing address
1251 NE ELM ST STE 1B, PRINEVILLE, OR 97754-3143
(541) 447-4688
(541) 447-1243
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
NPC-0002734
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275466
—
OR
Enumeration date
03/07/2007
Last updated
08/22/2020
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