# MEDTECH MEDICAL SUPPLY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073578514
- **Authorized official:** MR. OLAWALE AYOOLA OYETIBO (OFFICER)
- **Authorized official phone:** (626) 962-7580

## Contact information

- **Practice address:** 1331 W GARVEY AVE N, WEST COVINA, CA 91790-2242
- **Practice address phone:** (626) 962-7580
- **Practice address fax:** (626) 960-1659
- **Mailing address:** PO BOX 2098, POMONA, CA 91769-2098
- **Mailing address phone:** (909) 948-5895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 49380 | CA | Yes |

## Other

- **Enumeration date:** 04/18/2006
- **Last updated:** 02/05/2009
