Healthcare Provider Details

I. General information

NPI: 1972697902
Provider Name (Legal Business Name): US MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3718 FOOTHILL BOULEVARD
LA CRESCENTA CA
91214
US

IV. Provider business mailing address

3718 FOOTHILL BOULEVARD
LA CRESCENTA CA
91214
US

V. Phone/Fax

Practice location:
  • Phone: 818-542-4172
  • Fax: 818-542-4139
Mailing address:
  • Phone: 818-542-4172
  • Fax: 818-542-4139

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: ARTHUR AYVAZYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-542-4172