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General NPI Number Information
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NPI Number | 1992898647
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Entity Type | Organization
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Legal Business Name | CTR MEDICAL ENTERPRISES, INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 3898 CERRITOS AVE
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2420
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Country | US
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Telephone | 714-826-7890
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Fax | 714-826-7839
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Provider Business Mailing Address
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Address Line | 3898 CERRITOS AVE
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2420
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Country | US
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Telephone | 714-826-7890
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Fax | 714-826-7839
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Authorized Official
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Title or Position | OWNER
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Name | MR. HAROLD CLIFTON ROSS
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Credential |
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Telephone | 714-826-7890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 54666
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 54666
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License Number State | CA
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