Organization Name: | SIERRA BLACKSTON MEDICAL SUPPLY INC. |
NPI Number: | 1407993926 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GAGIK KHALATYAN (PRESIDENT) |
Mailing Address: | 6463 N Blackstone Ave Fresno |
State: | CA US |
Postal Code: | 937103508 |
Phone Number: | 5594324936 |
Fax Number: | 5594326236 |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 02/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 46540 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |