Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI Number | 1265603518 |
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| LBN Legal business name | GERARDO CERVANTES | ||||||||||||
| Authorized official | GERARDO CERVANTES - (OWNER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 03/14/2008 | ||||||||||||
| Last updated | 03/27/2013 - About 13 years ago | ||||||||||||
| Identifiers |
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