MEDICARE: HORIZON MEDICAL EQUIPMENT & SUPPLY, 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	43456	CA

General Provider Information

NPI Number	:	1558588533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON MEDICAL EQUIPMENT & SUPPLY, INC.

Provider Business Mailing Address
First Line	:	5511 SAN VICENTE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-2718
Country	:	US
Telephone Number	:	323-525-1829
Fax Number	:	323-525-1846

Provider Business Practice Location Address
First Line	:	5511 SAN VICENTE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-2718
Country	:	US
Telephone Number	:	323-525-1829
Fax Number	:	323-525-1846

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CONNIE IKPOH
Credential	:
Telephone Number	:	323-525-1829

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	11/14/2007

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