# AVASCO MEDICAL SUPPLY, INC

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

## Provider details

- **NPI number:** 1295053858
- **Authorized official:** MR. RANDY ABABSEH (PRESIDENT)
- **Authorized official phone:** (805) 522-5333

## Contact information

- **Practice address:** 4268 E LOS ANGELES AVE, SUITE \#102, SIMI VALLEY, CA 93063-3366
- **Practice address phone:** (805) 522-5333
- **Practice address fax:** (805) 522-6333
- **Mailing address:** 4268 E LOS ANGELES AVE, SUITE \#102, SIMI VALLEY, CA 93063-3366
- **Mailing address phone:** (805) 522-5333
- **Mailing address fax:** (805) 522-6333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0002402171-0001-2 | CA | Yes |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 51170 | CA | — |
| 335E00000X | Prosthetic/Orthotic Supplier | 0002402171-0001-2 | CA | — |

## Other

- **Enumeration date:** 05/06/2010
- **Last updated:** 11/10/2015