MEDICARE: PRONTO MEDICAL 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	0002513671-0001-2	CA

General Provider Information

NPI Number	:	1730492240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRONTO MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	1117 N HOLLYWOOD WAY
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2528
Country	:	US
Telephone Number	:	818-848-8060
Fax Number	:	818-848-8262

Provider Business Practice Location Address
First Line	:	1117 N HOLLYWOOD WAY
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2528
Country	:	US
Telephone Number	:	818-848-8060
Fax Number	:	818-848-8262

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GEORGY GIGILASHVILI
Credential	:
Telephone Number	:	818-848-8060

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	03/21/2011

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