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NPI Code Detail

MEDICARE: BURBANK MEDICAL SUPPLY, INC.

MEDICARE: BURBANK MEDICAL SUPPLY, 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
1332B00000XDurable Medical Equipment & Medical Supplies53069CA

Other Identifiers

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

General Provider Information

NPI Number : 1851391965
Entity Type Code : Organization
Provider Name (Legal Business Name) : BURBANK MEDICAL SUPPLY, INC.
Provider Business Mailing Address
First Line : 4302 W VICTORY BLVD
Second Line :
City : BURBANK
State : CA
Zip : 91505-1334
Country : US
Telephone Number : 818-845-2884
Fax Number : 818-845-3177
Provider Business Practice Location Address
First Line : 4302 W VICTORY BLVD
Second Line :
City : BURBANK
State : CA
Zip : 91505-1334
Country : US
Telephone Number : 818-845-2884
Fax Number : 818-845-3177
Authorized Official
Title or Position : PRESIDENT
Name : POURANG NASSI
Credential :
Telephone Number : 818-845-2884
Provider Enumeration Date : 07/29/2005
Last Update Date : 02/17/2010

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Directions to “BURBANK MEDICAL SUPPLY, INC. ” Practice Location

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