Healthcare Provider Details

I. General information

NPI: 1487975298
Provider Name (Legal Business Name): ON TIME MEDICAL EQUIPMENT & SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 06/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 E CHESTNUT ST
GLENDALE CA
91205-2174
US

IV. Provider business mailing address

113 E CHESTNUT ST
GLENDALE CA
91205-2174
US

V. Phone/Fax

Practice location:
  • Phone: 818-550-9988
  • Fax: 866-840-5513
Mailing address:
  • Phone: 818-550-9988
  • Fax: 866-840-5513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code331L00000X
TaxonomyBlood Bank
License Number127629833935
License Number StateCA

VIII. Authorized Official

Name: RUBEN KARAPETYAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 818-550-8899