Provider Demographics
NPI:1710037494
Name:E MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:E MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FORNFEIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-366-1918
Mailing Address - Street 1:18835 N LOWER SACRAMENTO RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:95258-9284
Mailing Address - Country:US
Mailing Address - Phone:209-366-1918
Mailing Address - Fax:209-366-2140
Practice Address - Street 1:18835 N LOWER SACRAMENTO RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CA
Practice Address - Zip Code:95258-9284
Practice Address - Country:US
Practice Address - Phone:209-366-1918
Practice Address - Fax:209-366-2140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4816260001Medicare NSC