Healthcare Provider Details

I. General information

NPI: 1497089023
Provider Name (Legal Business Name): OK MEDICAL EQUIPMENTS AND SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 CENTINELA AVE SUITE 6
INGLEWOOD CA
90302-1047
US

IV. Provider business mailing address

1626 CENTINELA AVE SUITE 6
INGLEWOOD CA
90302-1047
US

V. Phone/Fax

Practice location:
  • Phone: 323-747-5307
  • Fax:
Mailing address:
  • Phone: 323-743-6026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. OLUFEMI EMMANUEL KILANKO
Title or Position: OWNER
Credential: CEO
Phone: 323-743-6026