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General NPI Number Information
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NPI Number | 1437385747
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Entity Type | Organization
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Legal Business Name | NILE MEDICAL SUPPLIES INC.
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 2420 W MARTIN LUTHER KING JR BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90008-2727
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Country | US
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Telephone | 323-293-4204
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Fax | 323-293-2851
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Provider Business Mailing Address
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Address Line | 2420 W MARTIN LUTHER KING JR BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90008-2727
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Country | US
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Telephone | 323-293-4204
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Fax | 323-293-2851
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Authorized Official
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Title or Position | CEO
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Name | MR. PAULOS M AYELE
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Credential |
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Telephone | 323-293-4204
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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 | 50980
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License Number State | CA
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