MEDICARE: A.Y. MEDICAL SUPLLIES 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	47369	CA

General Provider Information

NPI Number	:	1972709467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A.Y. MEDICAL SUPLLIES INC.

Provider Business Mailing Address
First Line	:	2500 W ORANGETHORPE AVE
Second Line	:	SUITE 101
City	:	FULLERTON
State	:	CA
Zip	:	92833-4237
Country	:	US
Telephone Number	:	714-773-9777
Fax Number	:	714-773-9393

Provider Business Practice Location Address
First Line	:	2500 W ORANGETHORPE AVE
Second Line	:	SUITE 101
City	:	FULLERTON
State	:	CA
Zip	:	92833-4237
Country	:	US
Telephone Number	:	714-773-9777
Fax Number	:	714-773-9393

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MR. EKUNDAYO AYO ERHABOR
Credential	:
Telephone Number	:	714-773-9777

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	04/02/2008

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