# ANAHEIM MEDICAL SUPPLY INC.

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

## Provider details

- **NPI number:** 1306006259
- **Authorized official:** MYRNA C. IBALLA (SECRETARY)
- **Authorized official phone:** (714) 999-6710

## Contact information

- **Practice address:** 1256 N EUCLID ST, ANAHEIM, CA 92801-1928
- **Practice address phone:** (714) 999-6710
- **Practice address fax:** (714) 999-6712
- **Mailing address:** 1256 N EUCLID ST, ANAHEIM, CA 92801-1928
- **Mailing address phone:** (714) 999-6710
- **Mailing address fax:** (714) 999-6712

## Taxonomy

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

## Other

- **Enumeration date:** 06/13/2008
- **Last updated:** 06/13/2008