# FAIR OAKS MEDICAL SUPPLY, INC.

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

## Provider details

- **NPI number:** 1306002894
- **Authorized official:** LUSINE AVAGYAN (OWNER)
- **Authorized official phone:** (916) 482-1216

## Contact information

- **Practice address:** 5933 FAIR OAKS BLVD, CARMICHAEL, CA 95608
- **Practice address phone:** (916) 482-1216
- **Practice address fax:** (916) 482-1297
- **Mailing address:** 5933 FAIR OAKS BLVD, CARMICHAEL, CA 95608-5221
- **Mailing address phone:** (916) 482-1216
- **Mailing address fax:** (916) 482-1297

## Taxonomy

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

## Other

- **Enumeration date:** 08/04/2008
- **Last updated:** 07/11/2011