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General NPI Number Information
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NPI Number | 1770510869
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Entity Type | Organization
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Legal Business Name | MILLENNIUM MEDICAL PRODUCTS INC
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2300 W VICTORY BLVD
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City | BURBANK
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State | CA
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Zip | 91506-1256
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Country | US
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Telephone | 818-840-8061
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Fax | 818-840-8062
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Provider Business Mailing Address
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Address Line | 2300 W.VICTORY BL ST.B
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City | BURBANK
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State | CA
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Zip | 91506
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Country | US
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Telephone | 818-840-8061
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Fax | 818-840-8062
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. VARDAN NONE GILAVIAN
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Credential | OWNER
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Telephone | 818-840-8061
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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 | 43580
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License Number State | CA
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