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General NPI Number Information
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NPI Number | 1306090865
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Entity Type | Organization
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Legal Business Name | SMITTY MEDICAL SUPPLY INC.
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10719 S INGLEWOOD AVE SUITE E
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City | INGLEWOOD
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State | CA
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Zip | 90304-4810
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Country | US
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Telephone | 310-677-7911
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Fax | 310-667-7668
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Provider Business Mailing Address
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Address Line | 10719 S INGLEWOOD AVE SUITE E
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City | INGLEWOOD
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State | CA
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Zip | 90304-4810
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Country | US
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Telephone | 310-677-7911
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Fax | 310-677-7668
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DANIELLE D SMITH
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Credential |
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Telephone | 310-677-7911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | CA
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