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General NPI Number Information
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NPI Number | 1477796795
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Entity Type | Organization
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Legal Business Name | PRIMO MEDICAL SUPPLIES INC
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 17337 VENTURA BLVD SUITE 220
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City | ENCINO
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State | CA
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Zip | 91316-4039
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Country | US
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Telephone | 866-224-5811
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Fax | 818-235-0103
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Provider Business Mailing Address
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Address Line | 17337 VENTURA BLVD SUITE 220
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City | ENCINO
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State | CA
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Zip | 91316-4039
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Country | US
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Telephone | 866-224-5811
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Fax | 818-235-0103
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Authorized Official
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Title or Position | PRESIDENT
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Name | FAYSAL BAHNASSI
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Credential |
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Telephone | 818-909-3790
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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 | 50981
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License Number State | CA
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