Organization Name: | CORAL DESERT MEDICAL SUPPLY, LLC |
NPI Number: | 1528269990 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRADY FLYGARE (DIRECTOR) |
Mailing Address: | 1490 E Foremaster Dr Building B St George |
State: | UT US |
Postal Code: | 84790 |
Phone Number: | 4357734300 |
Fax Number: | 4357734299 |
NPI Enumeration Date: | 05/31/2007 |
NPI Last Update Date: | 11/27/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | F68728 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
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 |