# CAPITOL MEDICAL SUPPLY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CAPITOL MEDICAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124581053
- **Authorized official:** MRS. KAMERIA AHMED IBRAHIM (OWNER/PRESIDENT)
- **Authorized official phone:** (424) 247-8165

## Contact information

- **Practice address:** 3629 N SEPULVEDA BLVD \# 103, MANHATTAN BEACH, CA 90266-3632
- **Practice address phone:** (424) 247-8165
- **Practice address fax:** (424) 247-8830
- **Mailing address:** 3629 N SEPULVEDA BLVD \# 103, MANHATTAN BEACH, CA 90266-3632
- **Mailing address phone:** (424) 247-8165

## Taxonomy

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

## Other

- **Enumeration date:** 04/08/2019
- **Last updated:** 06/11/2019