MEDICARE: EMXX MEDICAL SUPPLIES

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

General Provider Information

NPI Number	:	1144356072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMXX MEDICAL SUPPLIES

Provider Business Mailing Address
First Line	:	PO BOX 5473
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90249-5473
Country	:	US
Telephone Number	:	310-768-8388
Fax Number	:	714-768-8414

Provider Business Practice Location Address
First Line	:	13904 CRENSHAW BLVD
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90249-2714
Country	:	US
Telephone Number	:	310-768-8388
Fax Number	:	310-768-8414

Authorized Official
Title or Position	:	OWNER
Name	:	MR. EMMANUEL EJIOFOR
Credential	:
Telephone Number	:	310-768-8388

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	08/22/2020

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