MEDICARE: ASSIST MEDICAL SUPPLIES 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	98715	CA

General Provider Information

NPI Number	:	1609379536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSIST MEDICAL SUPPLIES INC.

Provider Business Mailing Address
First Line	:	5250 W CENTURY BLVD STE 207
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5946
Country	:	US
Telephone Number	:	424-227-9800
Fax Number	:	888-699-6897

Provider Business Practice Location Address
First Line	:	5250 W CENTURY BLVD STE 207
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5946
Country	:	US
Telephone Number	:	424-227-9800
Fax Number	:	888-699-6897

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FITA TULU
Credential	:
Telephone Number	:	424-227-9800

Provider Enumeration Date	:	03/16/2018
Last Update Date	:	03/16/2018

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