MEDICARE: CITY STATIONS, 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

General Provider Information

NPI Number	:	1871705244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY STATIONS, INC.

Provider Business Mailing Address
First Line	:	1534 N MOORPARK RD
Second Line	:	420
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-5129
Country	:	US
Telephone Number	:	818-825-9439
Fax Number	:	866-317-1094

Provider Business Practice Location Address
First Line	:	1145 LINDERO CANYON RD
Second Line	:	D10
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-5475
Country	:	US
Telephone Number	:	818-706-2390
Fax Number	:	818-706-6093

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. LISA M NOVACEK
Credential	:	CERTIFIED PEDORTHIST
Telephone Number	:	818-825-9439

Provider Enumeration Date	:	05/05/2007
Last Update Date	:	08/22/2020

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