Providence Medical Supply Llc
Durable Medical Equipment & Medical Supplies
1125 N Mountain Ave, Ontario
California, 91762-1739
909-443-7115 Providence Medical Supply Llc is a Durable Medical Equipment & Medical Supplies in Ontario, California. It is located at 1125 N Mountain Ave, Ontario and it's customer support contact number is 909-443-7115. The authorized person of Providence Medical Supply Llc is Mr. Yusif J Salia who is Managing Director of this DME and his contact number is 213-379-1424. Providence Medical Supply Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Providence Medical Supply Llc is 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.
DME Supplier Details:
Providence Medical Supply Llc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Providence Medical Supply Llc |
| Type: | Durable Medical Equipment & Medical Supplies |
| Location: | 1125 N Mountain Ave, Ontario,
California, 91762-1739 |
| Phone: | 909-443-7115 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Yusif J Salia |
| Position: | Managing Director |
| Contact Number: | 213-379-1424 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1659096410 |
| NPI Enumeration Date: | 04 Oct, 2022 |
| NPI Last Update On: | 25 Dec, 2022 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Providence Medical Supply Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Durable Medical Equipment & Medical Supplies | | | Primary | |
Medicare Enrollment:
Providence Medical Supply Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 4385019207 | O20230406002291 | Providence Medical Supply Llc | DME SUPPLIER - MEDICAL SUPPLY COMPANY |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1125 N Mountain Ave,
Ontario, California |
| Zip: | 91762-1739 |
| Phone Number: | 909-443-7115 |
Patients can reach Providence Medical Supply Llc at
1125 N Mountain Ave, Ontario, California or can
call on customer care at 909-443-7115.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.