Provider Demographics
NPI:1194807297
Name:AIDS FOR DAILY LIVING, INC.
Entity type:Organization
Organization Name:AIDS FOR DAILY LIVING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PEREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-624-0900
Mailing Address - Street 1:1140 SUNSET BLVD
Mailing Address - Street 2:SUITE #140
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-3770
Mailing Address - Country:US
Mailing Address - Phone:916-624-0900
Mailing Address - Fax:916-624-9801
Practice Address - Street 1:1140 SUNSET BLVD
Practice Address - Street 2:SUITE #140
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-3770
Practice Address - Country:US
Practice Address - Phone:916-624-0900
Practice Address - Fax:916-624-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02293FOtherMEDICAL
CADMR00030ROtherBLUE SHIELD OF CALIFORNIA
CA1260450001Medicare ID - Type Unspecified