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General NPI Number Information
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NPI Number | 1497783492
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Entity Type | Organization
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Legal Business Name | BANKY MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 6824 LA TIJERA BLVD UNIT #3
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City | LOS ANGELES
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State | CA
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Zip | 90045-1924
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Country | US
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Telephone | 310-645-5877
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Fax | 310-338-0160
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Provider Business Mailing Address
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Address Line | 6824 LA TIJERA BLVD UNIT #3
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City | LOS ANGELES
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State | CA
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Zip | 90045-1924
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Country | US
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Telephone | 310-645-5877
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Fax | 310-338-0057
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LEKE ADESINA
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Credential |
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Telephone | 310-645-5877
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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 | 103110
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License Number State | CA
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