Individual provider · Type 1 NPI

Eloise Catherine Thacker, C70773

Durable Medical Equipment & Medical Supplies · San Bernardino, CA

NPI number 1730914458 Active

Practice location

355 E 21st St
San Bernardino, CA 92404-4824

Fax (909) 883-4834

Mailing address

355 E 21st St Ste J
San Bernardino, CA 92404-4851

Specialties and licenses

TaxonomyCodeLicense
Durable Medical Equipment & Medical Supplies Primary 332B00000XC70773 (CA)

Durable Medical Equipment & Medical Supplies: A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

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About NPI 1730914458

Eloise Catherine Thacker, C70773's National Provider Identifier is 1730914458, issued on Sep 3, 2024. The primary taxonomy on file is Durable Medical Equipment & Medical Supplies (332B00000X), and the practice location is in San Bernardino, CA. The record was last updated on Sep 3, 2024.