MEDICARE: FALL CONTROL SYSTEMS, LLC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1912225475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALL CONTROL SYSTEMS, LLC

Provider Business Mailing Address
First Line	:	1611 S PACIFIC COAST HWY
Second Line	:	SUITE 104
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5606
Country	:	US
Telephone Number	:	310-316-9200
Fax Number	:	800-779-7561

Provider Business Practice Location Address
First Line	:	1611 S PACIFIC COAST HWY
Second Line	:	SUITE 104
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5606
Country	:	US
Telephone Number	:	310-316-9200
Fax Number	:	800-779-7561

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. LARRY WARREN DREHS
Credential	:
Telephone Number	:	310-316-9200

Provider Enumeration Date	:	05/08/2010
Last Update Date	:	11/10/2011

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Directions to “FALL CONTROL SYSTEMS, LLC ” Practice Location

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