Organization Name: | JAMES A BLANCO |
NPI Number: | 1154480275 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES ANTHONY BLANCO (OWNER) |
Mailing Address: | 14 W 27th St Suite 26 Scottsbluff |
State: | NE US |
Postal Code: | 693614302 |
Phone Number: | 3086300888 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2006 |
NPI Last Update Date: | 07/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | 123 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |