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General NPI Number Information
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NPI Number | 1750471504
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Entity Type | Organization
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Legal Business Name | CONTEMPO MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 8505 CRENSHAW BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90305-1915
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Country | US
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Telephone | 323-295-9009
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Fax | 323-971-8294
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Provider Business Mailing Address
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Address Line | 8505 CRENSHAW BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90305-1915
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Country | US
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Telephone | 323-295-9009
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Fax | 323-971-8294
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUMMAI JOY IBRAHIM
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Credential |
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Telephone | 323-295-9009
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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 | 45428
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License Number State | CA
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