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General NPI Number Information
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NPI Number | 1437477072
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Entity Type | Organization
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Legal Business Name | S & S MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 5250 W CENTURY BLVD SUITE 201
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City | LOS ANGELES
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State | CA
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Zip | 90045-5972
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Country | US
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Telephone | 310-417-3643
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Fax | 310-417-3622
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Provider Business Mailing Address
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Address Line | 5250 W CENTURY BLVD SUITE 201
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City | LOS ANGELES
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State | CA
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Zip | 90045-5972
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Country | US
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Telephone | 310-417-3643
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Fax | 310-417-3622
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS SELAMAWIT ALEMU
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Credential |
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Telephone | 310-417-3643
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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 | 51902
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License Number State | CA
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