Healthcare Provider Details

I. General information

NPI: 1750156626
Provider Name (Legal Business Name): PURE QUALITY MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8332 SEPULVEDA BLVD UNIT 1
NORTH HILLS CA
91343-6529
US

IV. Provider business mailing address

8332 SEPULVEDA BLVD UNIT 1
NORTH HILLS CA
91343-6529
US

V. Phone/Fax

Practice location:
  • Phone: 818-987-7774
  • Fax:
Mailing address:
  • Phone: 818-987-7774
  • Fax:

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: AVAG KARAKHANYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-987-7774