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Organization
CANOGA MEDICAL SUPPLY, INC
Active
Organization
CANOGA MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW GIBBS (PRESIDENT)
(702) 793-9763
Entity
Organization
Contact information
Practice address
20944 SHERMAN WAY STE 111, CANOGA PARK, CA 91303-3628
(818) 330-1402
Mailing address
310 E 8TH ST, PORT ANGELES, WA 98362-6218
(360) 504-3807
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
03/31/2016
Last updated
11/08/2018
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