Provider Demographics
NPI:1336492545
Name:PALMEDEQ CORP
Entity Type:Organization
Organization Name:PALMEDEQ CORP
Other - Org Name:PALMEDEQ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:JUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-376-1900
Mailing Address - Street 1:2373 TELLER RD STE 105
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6083
Mailing Address - Country:US
Mailing Address - Phone:805-376-1900
Mailing Address - Fax:805-376-1918
Practice Address - Street 1:2373 TELLER RD STE 105
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-6083
Practice Address - Country:US
Practice Address - Phone:805-376-1900
Practice Address - Fax:805-376-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies