# MEDICAL SUPPLY OUTLET, INC.

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

## Provider details

- **NPI number:** 1356520191
- **Authorized official:** GENEANE HALEY (PRESIDENT)
- **Authorized official phone:** (310) 671-3522

## Contact information

- **Practice address:** 105 E 64TH PL, INGLEWOOD, CA 90302-1338
- **Practice address phone:** (310) 671-3522
- **Practice address fax:** (310) 671-3622
- **Mailing address:** 105 E 64TH PL, INGLEWOOD, CA 90302-1338
- **Mailing address phone:** (310) 671-3522
- **Mailing address fax:** (310) 671-3622

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 44751 | CA | Yes |

## Other

- **Enumeration date:** 10/29/2007
- **Last updated:** 10/29/2007