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General NPI Number Information
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NPI Number | 1407944952
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Entity Type | Organization
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Legal Business Name | HOPE MEDICAL SUPPLY
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 1410 3RD ST STE 11
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City | RIVERSIDE
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State | CA
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Zip | 92507-3422
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Country | US
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Telephone | 951-680-9141
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Fax |
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Provider Business Mailing Address
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Address Line | 1410 3RD ST STE 11
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City | RIVERSIDE
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State | CA
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Zip | 92507-3422
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Country | US
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Telephone | 951-680-9141
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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. YINKA O ADEFOWORA
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Credential |
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Telephone | 951-680-9141
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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 | 44536
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License Number State | CA
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