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General NPI Number Information
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NPI Number | 1396973871
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Entity Type | Organization
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Legal Business Name | A.K. DIRECT MEDICAL SUPPLIES
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 10/02/2009
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Provider Practice Location Address
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Address Line | 14121 S WESTERN AVE
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City | GARDENA
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State | CA
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Zip | 90249-3009
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Country | US
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Telephone | 310-329-1426
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Fax | 323-325-3557
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Provider Business Mailing Address
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Address Line | 14121 S WESTERN AVE
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City | GARDENA
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State | CA
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Zip | 90249-3009
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Country | US
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Telephone | 310-329-1426
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Fax | 323-325-3557
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | MR. ALONZO DOBSON
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Credential |
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Telephone | 310-329-1426
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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 | 51396
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License Number State | CA
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