Provider Demographics
NPI:1407024649
Name:VALORES MEDICAL SUPPLY
Entity type:Organization
Organization Name:VALORES MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVADOR
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-231-8964
Mailing Address - Street 1:4707 COMANCHE AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-4429
Mailing Address - Country:US
Mailing Address - Phone:915-231-8964
Mailing Address - Fax:915-351-6906
Practice Address - Street 1:4707 COMANCHE AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-4429
Practice Address - Country:US
Practice Address - Phone:915-231-8964
Practice Address - Fax:915-351-6906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies