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General NPI Number Information
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NPI Number | 1083409213
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Entity Type | Organization
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Legal Business Name | FIRSTCARE MED SUPPLY INC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 657 W HARVARD ST
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City | GLENDALE
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State | CA
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Zip | 91204-1107
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Country | US
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Telephone | 818-208-5121
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Fax | 818-208-5122
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Provider Business Mailing Address
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Address Line | 657 W HARVARD ST
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City | GLENDALE
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State | CA
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Zip | 91204-1107
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Country | US
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Telephone | 818-208-5121
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Fax | 818-208-5122
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMVEL ASHOTI POLADYAN
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Credential |
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Telephone | 818-538-1692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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