Healthcare Provider Details
I. General information
NPI: 1083885768
Provider Name (Legal Business Name): BEACHWOOD MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2008
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5027 HEINTZ ST STE A-C
BALDWIN PARK CA
91706-1817
US
IV. Provider business mailing address
5027 HEINTZ ST STE A-C
BALDWIN PARK CA
91706-1817
US
V. Phone/Fax
- Phone: 626-338-5300
- Fax: 626-338-5800
- Phone: 626-338-5300
- Fax: 626-338-5800
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 49803 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | MP00845 |
| License Number State | NV |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | 49803 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | MP00845 |
| License Number State | NV |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | 49803 |
| License Number State | CA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | MP00845 |
| License Number State | NV |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 49803 |
| License Number State | CA |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | MP00845 |
| License Number State | NV |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | 49803 |
| License Number State | CA |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | MP00845 |
| License Number State | NV |
VIII. Authorized Official
Name:
ALBERT
SOLIMAN
Title or Position: CEO
Credential: PHARMACIST
Phone: 626-625-7363