# BENNIEMAX MEDICAL SUPPLY INC

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

## Provider details

- **NPI number:** 1265565428
- **Authorized official:** MR. BETHRAM IKECHUKWU OGOKE (CEO)
- **Authorized official phone:** (213) 413-8508

## Contact information

- **Practice address:** 1644 WILSHIRE BLVD, SUITE 105, LOS ANGELES, CA 90017-1600
- **Practice address phone:** (213) 413-8508
- **Practice address fax:** (213) 413-8509
- **Mailing address:** 1644 WILSHIRE BLVD, SUITE 105, LOS ANGELES, CA 90017-1600
- **Mailing address phone:** (213) 413-8508
- **Mailing address fax:** (213) 413-8509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 3852080001 | CA | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 5893680001 | CA | Yes |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 07/30/2008