Healthcare Provider Details

I. General information

NPI: 1215861588
Provider Name (Legal Business Name): UNIONMEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 1/2 SANTA ANA ST
HUNTINGTON PARK CA
90255-6629
US

IV. Provider business mailing address

2530 1/2 SANTA ANA ST
HUNTINGTON PARK CA
90255-6629
US

V. Phone/Fax

Practice location:
  • Phone: 201-471-1283
  • Fax: 512-900-6260
Mailing address:
  • Phone: 201-471-1283
  • Fax: 512-900-6260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTIAN ROGERS
Title or Position: OWNER
Credential:
Phone: 201-741-1283