Healthcare Provider Details

I. General information

NPI: 1861673857
Provider Name (Legal Business Name): RUZER MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2007
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 CRENSHAW BLVD SUITE 204
TORRANCE CA
90504-1439
US

IV. Provider business mailing address

16300 CRENSHAW BLVD SUITE 204
TORRANCE CA
90504-1439
US

V. Phone/Fax

Practice location:
  • Phone: 310-354-0018
  • Fax: 310-354-0019
Mailing address:
  • Phone: 310-354-0018
  • Fax: 310-354-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number48139
License Number StateCA

VIII. Authorized Official

Name: EBENEZER O BANKOLE
Title or Position: PRESIDENT
Credential:
Phone: 310-354-0018