Provider Demographics
NPI:1629217229
Name:BOOM INVESTMENTS, INC.
Entity Type:Organization
Organization Name:BOOM INVESTMENTS, INC.
Other - Org Name:PRO CARE MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-627-0000
Mailing Address - Street 1:7031 KOLL CENTER PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-3133
Mailing Address - Country:US
Mailing Address - Phone:510-627-0000
Mailing Address - Fax:510-834-9700
Practice Address - Street 1:7031 KOLL CENTER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-3133
Practice Address - Country:US
Practice Address - Phone:510-627-0000
Practice Address - Fax:510-834-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51015332B00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6249720001Medicare NSC