MEDICARE: GLOBAL DME INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		CA

General Provider Information

NPI Number	:	1073817508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL DME INC.

Provider Business Mailing Address
First Line	:	10921 WILSHIRE BLVD STE 410
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4001
Country	:	US
Telephone Number	:	310-208-6104
Fax Number	:	310-208-7745

Provider Business Practice Location Address
First Line	:	4333 ADMIRALTY WAY
Second Line	:	UNIT 9
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-5469
Country	:	US
Telephone Number	:	310-306-8481
Fax Number	:	310-822-2645

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	HENRY G CAMPOS
Credential	:
Telephone Number	:	310-208-6104

Provider Enumeration Date	:	12/23/2010
Last Update Date	:	12/23/2010

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