Provider Demographics
NPI:1740753102
Name:DME SPECIALIST LLC
Entity Type:Organization
Organization Name:DME SPECIALIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAIDER
Authorized Official - Middle Name:
Authorized Official - Last Name:NAQVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-767-1288
Mailing Address - Street 1:PO BOX 661414
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95866-1414
Mailing Address - Country:US
Mailing Address - Phone:804-767-1288
Mailing Address - Fax:916-244-0700
Practice Address - Street 1:1257 FULTON AVE APT 6
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-7319
Practice Address - Country:US
Practice Address - Phone:804-767-1288
Practice Address - Fax:916-244-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies