Provider Demographics
NPI:1881802361
Name:SOMERTON MEDICAL SUPPLIES INC.
Entity type:Organization
Organization Name:SOMERTON MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-722-6737
Mailing Address - Street 1:1185 S 10TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364
Mailing Address - Country:US
Mailing Address - Phone:928-503-6758
Mailing Address - Fax:
Practice Address - Street 1:536 E MAIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:SOMERTON
Practice Address - State:AZ
Practice Address - Zip Code:85350-3640
Practice Address - Country:US
Practice Address - Phone:928-722-6737
Practice Address - Fax:928-722-6738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies