Broadway Medical Service & Supply, Inc
Organization Active NPI Durable Medical Equipment & Medical Supplies · Fortuna, CA
NPI 1851583538 · NPPES record last updated Aug 15, 2007
Key facts
- NPI
- 1851583538
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 100211 (CA)
- Legal business name
- BROADWAY MEDICAL SERVICE & SUPPLY, INC
- Practice address
- 899 Main St
Fortuna, CA 95540-1925 - Phone
- (707) 725-6944
- Fax
- (707) 725-1655
- NPI assigned
- Aug 15, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- DARR-B CORP
Authorized official
- Name
- Mr. Ronald Allan Biasca
- Title
- President
- Phone
- (707) 442-3719
National Provider Directory
Locations
899 Main St
Fortuna, CA 95540
Phone (707) 725-6944
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 100211 | CA | Yes |
Addresses
Primary practice location
899 Main St
Fortuna, CA 95540-1925
Mailing address
1034 Broadway
Eureka, CA 95501-0126
Phone (707) 442-3719
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DME03117F | Medicaid | CA |
Other providers in Fortuna, CA
- Brandon Eugene Bireley
- Diederik-Jan Frederick Bouwmeester
- Ashley Megan Bramlett
- Nathan Dario Brinckhaus
- Ruben E Brinckhaus
- Jennifer Brown
- Kelly Usborne Bruce
- Andrey Buie
- Susan Burgess
- Joan P. Butler
All providers in Fortuna, CA · Durable Medical Equipment & Medical Supplies in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.