Provider Demographics
NPI:1669097192
Name:AVANTI MEDICAL EQUIPMENT,LLC
Entity type:Organization
Organization Name:AVANTI MEDICAL EQUIPMENT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-556-8223
Mailing Address - Street 1:531 N ALTA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-3250
Mailing Address - Country:US
Mailing Address - Phone:760-556-8223
Mailing Address - Fax:
Practice Address - Street 1:531 N ALTA AVE STE B
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-3250
Practice Address - Country:US
Practice Address - Phone:760-556-8223
Practice Address - Fax:800-507-1641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies