Provider Demographics
NPI:1376771725
Name:3ACE MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:3ACE MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:AMECHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-327-0940
Mailing Address - Street 1:6900 BROCKTON AVE
Mailing Address - Street 2:STE 10
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3801
Mailing Address - Country:US
Mailing Address - Phone:951-327-0940
Mailing Address - Fax:951-253-9233
Practice Address - Street 1:6900 BROCKTON AVE
Practice Address - Street 2:STE 10
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3801
Practice Address - Country:US
Practice Address - Phone:951-327-0940
Practice Address - Fax:951-253-9233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51820332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6364270001Medicare NSC