Organization
NORTHERN HOME MEDICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD ANTONUCCI (CEO)
(530) 272-9021
Entity
Organization
Contact information
Practice address
930 IDAHO MARYLAND RD, GRASS VALLEY, CA 95945-5943
(530) 272-9021
(530) 272-2804
Mailing address
PO BOX 2568, GRASS VALLEY, CA 95945-2568
(530) 272-9021
(530) 272-2804
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME00370G
—
CA
Enumeration date
07/01/2006
Last updated
08/22/2020
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