| Organization Name: | PENINSULA BIOMEDICAL, INC. |
| NPI Number: | 1386795011 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANNDEE HAFNER (GENERAL MANAGER) |
| Mailing Address: | 108 Whispering Pines Dr Suite 115 Scotts Valley |
| State: | CA US |
| Postal Code: | 950664792 |
| Phone Number: | 8314309066 |
| Fax Number: | 8314309068 |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 07/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 2676 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |