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General NPI Number Information
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NPI Number | 1215188032
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Entity Type | Organization
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Legal Business Name | AM MEDICAL DISTRIBUTORS INC.
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 12/24/2008
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Provider Practice Location Address
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Address Line | 10418 S PRAIRIE AVE STE A
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City | INGLEWOOD
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State | CA
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Zip | 90303-1832
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Country | US
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Telephone | 310-673-7100
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Fax | 310-673-7101
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Provider Business Mailing Address
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Address Line | 10418 S PRAIRIE AVE STE A
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City | INGLEWOOD
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State | CA
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Zip | 90303-1832
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Country | US
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Telephone | 310-673-7100
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Fax | 310-673-7101
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Authorized Official
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Title or Position | OWNER/CEO
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Name | AUSIE MOTLEY
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Credential |
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Telephone | 310-673-7100
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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 | 035898
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License Number State | CA
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