Provider Demographics
NPI:1841693991
Name:DURAQUIP MEDICAL
Entity type:Organization
Organization Name:DURAQUIP MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLO
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:STORMOEN
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:800-818-5582
Mailing Address - Street 1:16496 BERNARDO CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2524
Mailing Address - Country:US
Mailing Address - Phone:800-818-5582
Mailing Address - Fax:888-886-9598
Practice Address - Street 1:16496 BERNARDO CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2524
Practice Address - Country:US
Practice Address - Phone:800-818-5582
Practice Address - Fax:888-886-9598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-03
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74874332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies