Organization
CITRUS PLAZA MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VLADIMIR TKACH (PRESIDENT)
(916) 765-9963
Entity
Organization
Contact information
Practice address
7433 GREENBACK LN STE H, CITRUS HEIGHTS, CA 95610-5696
(916) 765-9963
Mailing address
7433 GREENBACK LN STE H, CITRUS HEIGHTS, CA 95610-5696
(916) 765-9963
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0000012568
CA
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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