Provider Demographics
NPI:1710075718
Name:N&A MEDICAL SUPPLY
Entity Type:Organization
Organization Name:N&A MEDICAL SUPPLY
Other - Org Name:GEARY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERZHERITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:415-752-8040
Mailing Address - Street 1:5427 GEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2306
Mailing Address - Country:US
Mailing Address - Phone:415-752-8040
Mailing Address - Fax:415-752-0869
Practice Address - Street 1:5427 GEARY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2306
Practice Address - Country:US
Practice Address - Phone:415-752-8040
Practice Address - Fax:415-752-0869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHA461420332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA461420Medicaid
CA0557810001Medicare ID - Type UnspecifiedMEDICAL SUPPLY/PHARMACY