Provider Demographics
NPI:1942488127
Name:DR MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:DR MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:C
Authorized Official - Last Name:READSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-264-6694
Mailing Address - Street 1:9659 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-4803
Mailing Address - Country:US
Mailing Address - Phone:714-264-6694
Mailing Address - Fax:
Practice Address - Street 1:1125 N MAGNOLIA AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2638
Practice Address - Country:US
Practice Address - Phone:714-264-6694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies