Healthcare Provider Details

I. General information

NPI: 1992912406
Provider Name (Legal Business Name): MERCY MEDICAL SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 W ALONDRA BLVD SUITE 6
COMPTON CA
90220-3533
US

IV. Provider business mailing address

1410 W ALONDRA BLVD SUITE 6
COMPTON CA
90220-3533
US

V. Phone/Fax

Practice location:
  • Phone: 310-637-6993
  • Fax: 310-637-2342
Mailing address:
  • Phone: 310-637-6993
  • Fax: 310-637-2342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number103688
License Number StateCA

VIII. Authorized Official

Name: ANGEL MICHEL JR.
Title or Position: PRESIDENT
Credential:
Phone: 310-637-6993