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General NPI Number Information
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NPI Number | 1659305969
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Entity Type | Organization
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Legal Business Name | GREATER HEALTH MEDICAL SUPPLY
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 2204 TORRANCE BLVD SUITE 101B
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City | TORRANCE
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State | CA
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Zip | 90501-2544
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Country | US
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Telephone | 310-787-1731
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Fax | 310-787-1771
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Provider Business Mailing Address
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Address Line | 2204 TORRANCE BLVD SUITE 101B
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City | TORRANCE
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State | CA
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Zip | 90501-2544
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Country | US
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Telephone | 310-787-1731
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Fax | 310-787-1771
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Authorized Official
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Title or Position | OWNER
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Name | MR. ADEOYE MOSES OGUNLADE
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Credential |
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Telephone | 310-787-1731
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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 | 5413670001
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License Number State | CA
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