MEDICARE: WOODLEY MEDICAL EQUIPMENT

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	03395670	CA

General Provider Information

NPI Number	:	1558393215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLEY MEDICAL EQUIPMENT

Provider Business Mailing Address
First Line	:	16156 SAN FERNANDO MISSIN BL
Second Line	:	#2
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-3807
Country	:	US
Telephone Number	:	818-366-3498
Fax Number	:

Provider Business Practice Location Address
First Line	:	16156 SAN FERNANDO MISSIN BL
Second Line	:	#2
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-3807
Country	:	US
Telephone Number	:	818-366-3498
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ARTUR LABLADZHYAN
Credential	:
Telephone Number	:	818-366-3498

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	08/22/2020

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