Organization Name: | ENDEAVOR MEDICAL SUPPLY |
NPI Number: | 1356767545 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARILIN VARGAS (OWNER) |
Mailing Address: | 7851 Walker St Ste 102 La Palma |
State: | CA US |
Postal Code: | 906231734 |
Phone Number: | 7145221500 |
Fax Number: | 7145221503 |
NPI Enumeration Date: | 03/12/2014 |
NPI Last Update Date: | 03/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |