Provider Demographics
NPI:1497824437
Name:CORE MEDICAL PRODUCTS, INC
Entity Type:Organization
Organization Name:CORE MEDICAL PRODUCTS, INC
Other - Org Name:WILLIAM H FITZSIMMONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:FITZSIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-478-9728
Mailing Address - Street 1:24769 REDLANDS BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4029
Mailing Address - Country:US
Mailing Address - Phone:909-478-9728
Mailing Address - Fax:909-478-9627
Practice Address - Street 1:24769 REDLANDS BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-4029
Practice Address - Country:US
Practice Address - Phone:909-478-9728
Practice Address - Fax:909-478-9627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME 02251FMedicaid
CA5054660001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER