Provider Demographics
NPI:1013375112
Name:CMM SUPPLIES, LLC
Entity Type:Organization
Organization Name:CMM SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-353-2773
Mailing Address - Street 1:8267 E MERRYWEATHER LN
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-2317
Mailing Address - Country:US
Mailing Address - Phone:714-542-5999
Mailing Address - Fax:866-627-8003
Practice Address - Street 1:1901 E 4TH ST STE 210
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3918
Practice Address - Country:US
Practice Address - Phone:714-542-5999
Practice Address - Fax:866-627-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies