# PRESTIGE ENTERPRISE A MEDICAL SUPPLY CO.

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

## Provider details

- **NPI number:** 1356354807
- **Authorized official:** MR. GODFREY U. NWOGENE (PRESIDENT)
- **Authorized official phone:** (310) 515-0979

## Contact information

- **Practice address:** 1113 W GARDENA BLVD, SUITE A, GARDENA, CA 90247-4887
- **Practice address phone:** (310) 515-0979
- **Practice address fax:** (310) 515-1290
- **Mailing address:** 1113 W GARDENA BLVD, SUITE A, GARDENA, CA 90247-4887
- **Mailing address phone:** (310) 515-0979

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 332B0000X | CA | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 10/29/2008