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General NPI Number Information
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NPI Number | 1235315680
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Entity Type | Organization
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Legal Business Name | NORTH HOLLYWOOD MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 10548 VICTORY BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3922
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Country | US
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Telephone | 818-763-6336
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Fax | 818-763-6397
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Provider Business Mailing Address
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Address Line | 10548 VICTORY BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3922
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Country | US
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Telephone | 818-763-6336
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Fax | 818-763-6397
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSANNA CHEKMIYAN
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Credential |
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Telephone | 818-763-6336
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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 | 48627
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License Number State | CA
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