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General NPI Number Information
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NPI Number | 1467697557
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Entity Type | Organization
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Legal Business Name | GERTHILL MEDICAL SUPPLY
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 825 W GARDENA BLVD
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City | GARDENA
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State | CA
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Zip | 90247-4999
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Country | US
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Telephone | 310-327-6977
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Fax | 310-327-6980
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Provider Business Mailing Address
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Address Line | 825 W GARDENA BLVD
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City | GARDENA
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State | CA
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Zip | 90247-4999
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Country | US
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Telephone | 310-327-6977
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Fax | 310-327-6980
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Authorized Official
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Title or Position | CEO
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Name | MRS. GERTRUDE ULOMA IHENACHOR
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Credential |
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Telephone | 310-327-6977
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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 | 49345
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License Number State | CA
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