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General NPI Number Information
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NPI Number | 1306822952
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Entity Type | Organization
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Legal Business Name | QUORUM MEDICAL SUPPLY INC.
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2521 N GRAND AVE SUITE B
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City | SANTA ANA
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State | CA
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Zip | 92705-8725
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Country | US
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Telephone | 714-538-2365
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Fax | 714-538-2367
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Provider Business Mailing Address
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Address Line | 2521 N GRAND AVE SUITE B
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City | SANTA ANA
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State | CA
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Zip | 92705-8725
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Country | US
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Telephone | 714-538-2365
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Fax | 714-538-2367
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ABIOLA LAWAL
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Credential |
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Telephone | 949-923-0250
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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 | 103327
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License Number State | CA
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