Provider Demographics
NPI:1689813420
Name:RAM DURABLE MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:RAM DURABLE MEDICAL EQUIPMENT
Other - Org Name:SOUTHERN CALIFORNIA ORTHOPEDIC REHAB EQUIPMENT (SCORE)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GRADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-852-2276
Mailing Address - Street 1:7909 SILVERTON AVE
Mailing Address - Street 2:#214
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6347
Mailing Address - Country:US
Mailing Address - Phone:858-549-1771
Mailing Address - Fax:858-549-1777
Practice Address - Street 1:7909 SILVERTON AVE
Practice Address - Street 2:#214
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6347
Practice Address - Country:US
Practice Address - Phone:858-549-1771
Practice Address - Fax:858-549-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9222139Medicaid
CA6310290001Medicare NSC