Provider Demographics
NPI:1922506856
Name:HERNIMARC DURABLE MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:HERNIMARC DURABLE MEDICAL EQUIPMENT
Other - Org Name:HERNIMARC DURABLE MEDICAL EQUIPMENT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-878-4561
Mailing Address - Street 1:1350 E MCKELLIPS RD STE 5
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-2739
Mailing Address - Country:US
Mailing Address - Phone:480-878-4561
Mailing Address - Fax:
Practice Address - Street 1:1350 E MCKELLIPS RD STE 3
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203
Practice Address - Country:US
Practice Address - Phone:480-878-4561
Practice Address - Fax:480-878-4589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition