Provider Demographics
NPI:1346224888
Name:MASTER MEDICAL SUPPLY
Entity Type:Organization
Organization Name:MASTER MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-564-8080
Mailing Address - Street 1:PO BOX 6786
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93160-6786
Mailing Address - Country:US
Mailing Address - Phone:805-564-8080
Mailing Address - Fax:805-564-8084
Practice Address - Street 1:22 N MILPAS ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-3300
Practice Address - Country:US
Practice Address - Phone:805-564-8080
Practice Address - Fax:805-564-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA043596116332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies