MEDICARE: SNUO MEDICAL SERVICES, 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	46984	CA

General Provider Information

NPI Number	:	1700906229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SNUO MEDICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	6420 S NORMANDIE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-2630
Country	:	US
Telephone Number	:	323-753-7766
Fax Number	:	323-753-7767

Provider Business Practice Location Address
First Line	:	6420 S NORMANDIE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-2630
Country	:	US
Telephone Number	:	323-753-7766
Fax Number	:	323-753-7767

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID O OFUOKWU
Credential	:
Telephone Number	:	323-753-7766

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	10/30/2007

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