Organization
DME SUPPLY PLACE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSLAN BOLOCHAN (PRESIDENT)
(602) 993-5508
Entity
Organization
Contact information
Practice address
15224 N 59TH AVE, 2, GLENDALE, AZ 85306-3215
(602) 993-5508
(602) 993-5521
Mailing address
15224 N 59TH AVE, 2, GLENDALE, AZ 85306-3215
(602) 993-5508
(602) 993-5521
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
20177241
AZ
Other
Enumeration date
08/13/2007
Last updated
01/28/2008
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