Healthcare Provider Details
I. General information
NPI: 1497793871
Provider Name (Legal Business Name): SARAH MEDICAL EQUIPMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2006
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14412 HAMLIN ST
VAN NUYS CA
91401-1409
US
IV. Provider business mailing address
2632 LINCOLN BLVD
SANTA MONICA CA
90405-4620
US
V. Phone/Fax
- Phone: 310-396-5258
- Fax: 310-496-2765
- Phone: 310-396-5258
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | SR AS 99883063 |
| License Number State | CA |
VIII. Authorized Official
Name:
MAHMOUD
SALARKIA
Title or Position: CEO
Credential:
Phone: 310-396-5258