MEDICARE: LIMERICK INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	350160	CA

General Provider Information

NPI Number	:	1275706962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMERICK INC.

Provider Business Mailing Address
First Line	:	2150 N GLENOAKS BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2827
Country	:	US
Telephone Number	:	818-566-3060
Fax Number	:	818-566-1260

Provider Business Practice Location Address
First Line	:	2150 N GLENOAKS BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2827
Country	:	US
Telephone Number	:	818-566-3060
Fax Number	:	818-566-1260

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. PATRICIA KELLY
Credential	:	RD, CLC
Telephone Number	:	818-566-3060

Provider Enumeration Date	:	04/02/2008
Last Update Date	:	04/02/2008

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Directions to “LIMERICK INC. ” Practice Location

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