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General NPI Number Information
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NPI Number | 1245353556
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Entity Type | Organization
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Legal Business Name | VERDUGO MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 2614 ARTHUR ST SUITE A
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City | LOS ANGELES
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State | CA
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Zip | 90065-2859
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Country | US
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Telephone | 818-408-1160
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Fax |
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Provider Business Mailing Address
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Address Line | 2614 ARTHUR ST SUITE A
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City | LOS ANGELES
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State | CA
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Zip | 90065-2859
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Country | US
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Telephone | 818-408-1160
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ARMEN SARGSYAN
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Credential |
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Telephone | 818-408-1160
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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 | 000218940200011
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License Number State | CA
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