Provider Demographics
NPI:1265684146
Name:REALM INDUSTRIES
Entity Type:Organization
Organization Name:REALM INDUSTRIES
Other - Org Name:FRIEND CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:NEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-905-4969
Mailing Address - Street 1:3105 QUARTZ LN #2
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831
Mailing Address - Country:US
Mailing Address - Phone:714-905-4969
Mailing Address - Fax:
Practice Address - Street 1:3105 QUARTZ LN APT 2
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-2537
Practice Address - Country:US
Practice Address - Phone:714-905-4969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies