Provider Demographics
NPI:1255499588
Name:ALMA MEDICAL SUPPLIES AND DISTRIBUTORS
Entity Type:Organization
Organization Name:ALMA MEDICAL SUPPLIES AND DISTRIBUTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:
Authorized Official - Last Name:AGYIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-371-2562
Mailing Address - Street 1:1490 W. RINCON ST.
Mailing Address - Street 2:UNIT E
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-9201
Mailing Address - Country:US
Mailing Address - Phone:909-371-2562
Mailing Address - Fax:909-371-9490
Practice Address - Street 1:1490 W. RINCON ST.
Practice Address - Street 2:UNIT E
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-9201
Practice Address - Country:US
Practice Address - Phone:909-371-2562
Practice Address - Fax:909-371-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103163332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies