Healthcare Provider Details

I. General information

NPI: 1881269769
Provider Name (Legal Business Name): CARETECH MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6819 SEPULVEDA BLVD STE 205
VAN NUYS CA
91405-4440
US

IV. Provider business mailing address

6819 SEPULVEDA BLVD STE 205
VAN NUYS CA
91405-4440
US

V. Phone/Fax

Practice location:
  • Phone: 747-264-1712
  • Fax: 747-264-1706
Mailing address:
  • Phone: 747-264-1712
  • Fax: 747-264-1706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. ARMAN GAMBARYAN
Title or Position: CEO/PRESIDENT
Credential:
Phone: 747-264-1712