Provider Demographics
NPI:1346486263
Name:NUTREND MEDICAL
Entity Type:Organization
Organization Name:NUTREND MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENI
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTEMAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-226-9191
Mailing Address - Street 1:3035 CARSON DR
Mailing Address - Street 2:# 2
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-7743
Mailing Address - Country:US
Mailing Address - Phone:530-336-9191
Mailing Address - Fax:
Practice Address - Street 1:3035 CARSON DR
Practice Address - Street 2:#2
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-7743
Practice Address - Country:US
Practice Address - Phone:530-226-9191
Practice Address - Fax:530-226-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies