MEDICARE: GAP MEDICAL EQUIPMENT 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	000254888600011	CA

General Provider Information

NPI Number	:	1710277819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAP MEDICAL EQUIPMENT INC.

Provider Business Mailing Address
First Line	:	6135 VINELAND AVE.
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-4913
Country	:	US
Telephone Number	:	818-985-4500
Fax Number	:	818-985-4501

Provider Business Practice Location Address
First Line	:	6135 VINELAND AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-4913
Country	:	US
Telephone Number	:	818-985-4500
Fax Number	:	818-985-4501

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. ARMEN AVAGYAN
Credential	:
Telephone Number	:	818-985-4500

Provider Enumeration Date	:	04/11/2011
Last Update Date	:	11/22/2011

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