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General NPI Number Information
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NPI Number | 1205373198
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Entity Type | Organization
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Legal Business Name | PREMIER HEALTHCARE AND SUPPLIES
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11600 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90025-5781
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Country | US
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Telephone | 310-444-2911
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Fax | 818-737-7201
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Provider Business Mailing Address
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Address Line | 23705 VANOWEN ST 132
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City | WEST HILLS
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State | CA
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Zip | 91307-3030
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Country | US
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Telephone | 818-912-7004
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Fax | 818-737-7201
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Authorized Official
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Title or Position | PRESIDENT/MEDICAL DIRECTOR
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Name | DR. STEVEN L ROSENBLATT
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Credential | MD
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Telephone | 310-444-2911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | A53639
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License Number State | CA
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