Provider Demographics
NPI:1033178892
Name:DECLAN MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:DECLAN MEDICAL EQUIPMENT, INC.
Other - Org Name:WESTERN REHAB SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MEG
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNIECE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-313-5770
Mailing Address - Street 1:825 ARNOLD DRIVE SUITE 112
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553
Mailing Address - Country:US
Mailing Address - Phone:925-313-5770
Mailing Address - Fax:925-313-5799
Practice Address - Street 1:825 ARNOLD DRIVE SUITE 112
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553
Practice Address - Country:US
Practice Address - Phone:925-313-5770
Practice Address - Fax:925-313-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME01439GMedicaid
CA1188670001Medicare ID - Type Unspecified