Provider Demographics
NPI:1740428267
Name:CAL CITY MEDICAL SUPPLY INC.
Entity Type:Organization
Organization Name:CAL CITY MEDICAL SUPPLY INC.
Other - Org Name:SMART REMEDIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-705-0007
Mailing Address - Street 1:715 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-4309
Mailing Address - Country:US
Mailing Address - Phone:334-705-0007
Mailing Address - Fax:334-363-2786
Practice Address - Street 1:715 1ST AVE
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-4309
Practice Address - Country:US
Practice Address - Phone:334-705-0007
Practice Address - Fax:334-363-2786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6378000001Medicare NSC