Provider Demographics
NPI:1962682302
Name:COAST TO COAST MEDICAL EQUIPMENT REPAIR
Entity Type:Organization
Organization Name:COAST TO COAST MEDICAL EQUIPMENT REPAIR
Other - Org Name:COAST TO COAST MEDICAL EQUIPMENT REPAIR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:OJEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-657-5296
Mailing Address - Street 1:1088 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-2824
Mailing Address - Country:US
Mailing Address - Phone:805-657-5296
Mailing Address - Fax:
Practice Address - Street 1:1088 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-2824
Practice Address - Country:US
Practice Address - Phone:805-657-5296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6391780001Medicare NSC