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General NPI Number Information
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NPI Number | 1568541829
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Entity Type | Organization
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Legal Business Name | WEST CORNER MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 905 SOUTH PRAIRE AVE STE D
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City | INGLEWOOD
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State | CA
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Zip | 90301
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Country | US
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Telephone | 310-673-9580
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Fax | 310-673-9587
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Provider Business Mailing Address
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Address Line | 905 SOUTH PRAIRE AVENUE SUITE
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City | INGLEWOOD
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State | CA
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Zip | 90301
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Country | US
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Telephone | 310-673-9580
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Fax | 310-673-9587
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Authorized Official
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Title or Position | MANAGER
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Name | MR. OBINNA A OKOLI
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Credential |
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Telephone | 310-673-9580
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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 | 46171
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License Number State | CA
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