Healthcare Provider Details

I. General information

NPI: 1396045100
Provider Name (Legal Business Name): HI-MED SUPPLY CO. INC..
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2010
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9551 1/4 TELEGRAPH RD
PICO RIVERA CA
90660-5523
US

IV. Provider business mailing address

9551 1/4 TELEGRAPH RD
PICO RIVERA CA
90660-5523
US

V. Phone/Fax

Practice location:
  • Phone: 562-948-4848
  • Fax:
Mailing address:
  • Phone: 562-948-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License NumberPENDING
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MISS SOWO VARNEY
Title or Position: PRESIDENT
Credential:
Phone: 562-948-4848