# CANOGA MEDICAL SUPPLY, INC

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

## Provider details

- **NPI number:** 1295198984
- **Authorized official:** MATTHEW GIBBS (PRESIDENT)
- **Authorized official phone:** (702) 793-9763

## Contact information

- **Practice address:** 20944 SHERMAN WAY STE 111, CANOGA PARK, CA 91303-3628
- **Practice address phone:** (818) 330-1402
- **Mailing address:** 310 E 8TH ST, PORT ANGELES, WA 98362-6218
- **Mailing address phone:** (360) 504-3807

## Taxonomy

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

## Other

- **Enumeration date:** 03/31/2016
- **Last updated:** 11/08/2018