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Organization
MEDICAL SUPPLY DEPOT
Active
Organization
MEDICAL SUPPLY DEPOT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORBERTO PURUGGANAN BARROGA (PRESIDENT)
(323) 773-6522
Entity
Organization
Contact information
Practice address
4846 FLORENCE AVE, SUITE #B104, BELL, CA 90201-4317
(323) 773-6522
(323) 773-8950
Mailing address
4846 FLORENCE AVE., SUITE #B104, BELL, CA 90201-4399
(323) 773-6522
(323) 773-8950
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
44656
CA
3336C0003X
Community/Retail Pharmacy
PHY 50801
CA
335E00000X
Prosthetic/Orthotic Supplier
—
NULL
Other
Enumeration date
06/30/2006
Last updated
02/03/2012
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