Provider Demographics
NPI:1194863811
Name:F & R MEDICAL SUPPLY
Entity Type:Organization
Organization Name:F & R MEDICAL SUPPLY
Other - Org Name:F & R MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ONNEKIKAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-956-9930
Mailing Address - Street 1:14465 MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-4699
Mailing Address - Country:US
Mailing Address - Phone:760-956-9930
Mailing Address - Fax:760-956-9931
Practice Address - Street 1:14465 MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-4699
Practice Address - Country:US
Practice Address - Phone:760-956-9930
Practice Address - Fax:760-956-9931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46544332B00000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5938770001Medicare NSC