# MIRR GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prime Medical Supplies, Medixcal
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588258289
- **Authorized official:** ILGAR SEYEDI (OWNER)
- **Authorized official phone:** (818) 900-0710

## Contact information

- **Practice address:** 14942 DELANO ST, VAN NUYS, CA 91411-2122
- **Practice address phone:** (818) 900-0710
- **Mailing address:** 14942 DELANO ST, VAN NUYS, CA 91411-2122
- **Mailing address phone:** (818) 900-0710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | — | NULL | — |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |

## Other

- **Enumeration date:** 02/23/2021
- **Last updated:** 02/23/2021