Provider Demographics
NPI:1487757423
Name:PRIDE MEDICAL SUPPLIES
Entity type:Organization
Organization Name:PRIDE MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VALENTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNTEANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-874-5831
Mailing Address - Street 1:7620 E MC KELLIPS RD.
Mailing Address - Street 2:#9
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:58257
Mailing Address - Country:US
Mailing Address - Phone:480-874-5831
Mailing Address - Fax:480-874-4839
Practice Address - Street 1:303 MILLER RD
Practice Address - Street 2:#2019
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:58257
Practice Address - Country:US
Practice Address - Phone:818-207-1449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20127464332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies