Provider Demographics
NPI:1750512232
Name:BAY AREA MEDICAL SUPPLY SALES AND RENTALS LLC
Entity Type:Organization
Organization Name:BAY AREA MEDICAL SUPPLY SALES AND RENTALS LLC
Other - Org Name:BRADFORD MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-230-0000
Mailing Address - Street 1:467 NORWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5963
Mailing Address - Country:US
Mailing Address - Phone:408-230-0000
Mailing Address - Fax:
Practice Address - Street 1:467 NORWOOD CIR
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5963
Practice Address - Country:US
Practice Address - Phone:408-230-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200711110232332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies