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General NPI Number Information
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NPI Number | 1962675256
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Entity Type | Organization
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Legal Business Name | M & D MEDICAL SUPPLY INC.
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 5250 W CENTURY BLVD SUITE 304
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City | LOS ANGELES
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State | CA
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Zip | 90045-5972
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Country | US
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Telephone | 310-467-1950
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Fax | 310-337-1180
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Provider Business Mailing Address
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Address Line | 5250 W CENTURY BLVD SUITE 304
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City | LOS ANGELES
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State | CA
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Zip | 90045-5972
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Country | US
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Telephone | 310-467-1950
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Fax | 310-337-1180
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Authorized Official
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Title or Position | OWNER
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Name | AMSALE MAMO
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Credential |
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Telephone | 310-770-4771
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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 | 48971
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License Number State | CA
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