MEDICARE: A C T 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679681340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A C T MEDICAL SUPPLIES, INC

Provider Business Mailing Address
First Line	:	2928 WESTMINSTER AVE
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-5305
Country	:	US
Telephone Number	:	562-430-6140
Fax Number	:	562-430-6143

Provider Business Practice Location Address
First Line	:	2928 WESTMINSTER AVE
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-5305
Country	:	US
Telephone Number	:	562-430-6140
Fax Number	:	562-430-6143

Authorized Official
Title or Position	:	OWNER/SECRETARY
Name	:	MRS. KHATOL M HASSANZADI
Credential	:
Telephone Number	:	562-430-6140

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	02/02/2011

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