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Organization
CUSTODIAN INCORPORATION
Active
Organization
CUSTODIAN INCORPORATION
Active
Other names
CUSTODIAN MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AKINOLA KODJO SAGOE (PRESIDENT)
(310) 833-1190
Entity
Organization
Contact information
Practice address
1891 N GAFFEY STREET, SUITE L, SAN PEDRO, CA 90731
(310) 833-1190
(310) 833-1196
Mailing address
1891 N GAFFEY STREET, SUITE L, SAN PEDRO, CA 90731
(310) 833-1190
(310) 833-1196
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
06/03/2008
Last updated
10/02/2008
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