MEDICARE: ATNA MEDICAL SUPPLY

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

General Provider Information

NPI Number	:	1366638066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATNA MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	10523 BURBANK BLVD # 108
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2233
Country	:	US
Telephone Number	:	818-763-0420
Fax Number	:	818-763-0422

Provider Business Practice Location Address
First Line	:	10523 BURBANK BLVD # 108
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2233
Country	:	US
Telephone Number	:	818-763-0420
Fax Number	:	818-763-0422

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ZINAIDA D POCHARD
Credential	:
Telephone Number	:	818-763-0420

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	03/23/2010

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Directions to “ATNA MEDICAL SUPPLY ” Practice Location

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