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General NPI Number Information
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NPI Number | 1376689612
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Entity Type | Organization
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Legal Business Name | PACIFIC MEDICAL EQUIPMENT AND SUPPLIES INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 2140 W 95TH ST
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City | CHICAGO
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State | IL
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Zip | 60643-1019
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Country | US
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Telephone | 773-238-3440
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Fax | 773-238-3450
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Provider Business Mailing Address
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Address Line | 2140 W 95TH ST
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City | CHICAGO
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State | IL
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Zip | 60643-1019
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Country | US
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Telephone | 773-238-3440
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Fax | 773-238-3450
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | SAMUEL E OKORO
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Credential |
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Telephone | 773-238-3440
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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 |
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License Number State | IL
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