Provider Demographics
NPI:1750826889
Name:NATIONWIDE MEDICAL, INC
Entity Type:Organization
Organization Name:NATIONWIDE MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-338-3500
Mailing Address - Street 1:29901 AGOURA RD
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-2513
Mailing Address - Country:US
Mailing Address - Phone:818-338-3500
Mailing Address - Fax:
Practice Address - Street 1:5150 N UNION BLVD
Practice Address - Street 2:SUITE 103 A
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-2075
Practice Address - Country:US
Practice Address - Phone:719-594-2024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20166001302332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies