Provider Demographics
NPI:1346526902
Name:SERVE ALL MEDICAL SUPPLIES
Entity type:Organization
Organization Name:SERVE ALL MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-302-9044
Mailing Address - Street 1:4101 AMARGOSA DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8243
Mailing Address - Country:US
Mailing Address - Phone:510-302-9044
Mailing Address - Fax:209-839-0731
Practice Address - Street 1:4101 AMARGOSA DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8243
Practice Address - Country:US
Practice Address - Phone:510-302-9044
Practice Address - Fax:209-839-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies