Healthcare Provider Details

I. General information

NPI: 1013154798
Provider Name (Legal Business Name): OLIVEVIEW MEDICAL SUPPLY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2009
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 E PALMDALE BLVD SUITE C
PALMDALE CA
93550-4896
US

IV. Provider business mailing address

1334 E PALMDALE BLVD SUITE C
PALMDALE CA
93550-4896
US

V. Phone/Fax

Practice location:
  • Phone: 661-339-2992
  • Fax: 661-339-2390
Mailing address:
  • Phone: 661-339-2992
  • Fax: 661-339-2390

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: OLIVE J UMEH
Title or Position: DIRECTOR
Credential:
Phone: 818-983-4983