Provider Demographics
NPI:1235379025
Name:GUAM MATTRESS WAREHOUSE
Entity Type:Organization
Organization Name:GUAM MATTRESS WAREHOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BURROWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-634-4664
Mailing Address - Street 1:9089 CLAIREMONT MESA BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1225
Mailing Address - Country:US
Mailing Address - Phone:858-560-1690
Mailing Address - Fax:858-514-8900
Practice Address - Street 1:146 TAITANO ROAD
Practice Address - Street 2:
Practice Address - City:HARMON
Practice Address - State:GU
Practice Address - Zip Code:96911
Practice Address - Country:US
Practice Address - Phone:671-647-2337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUAM MOVERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies