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General NPI Number Information
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NPI Number | 1831362623
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Entity Type | Organization
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Legal Business Name | VAPOR MEDICAL DISTRIBUTORS INC.
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 03/25/2009
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Provider Practice Location Address
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Address Line | 2411 MARINE AVE
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City | GARDENA
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State | CA
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Zip | 90249-3726
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Country | US
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Telephone | 310-538-1773
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Fax |
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Provider Business Mailing Address
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Address Line | 2411 MARINE AVE
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City | GARDENA
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State | CA
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Zip | 90249-3726
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Country | US
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Telephone | 310-538-1773
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | ADEKUNLE OGUNBANWO
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Credential |
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Telephone | 310-538-1773
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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 | 49950
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License Number State | CA
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