MEDICARE: CHH 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	:	1760651269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHH MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	13653 VICTORY BLVD
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-1735
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13653 VICTORY BLVD
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-1735
Country	:	US
Telephone Number	:	818-785-5002
Fax Number	:	818-785-9246

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZA SHUBARALYAN
Credential	:
Telephone Number	:	818-785-5002

Provider Enumeration Date	:	02/28/2008
Last Update Date	:	02/28/2008

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