# ACTIVE MEDICAL EQUIPMENT & SUPPLIS

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

## Provider details

- **NPI number:** 1619993029
- **Authorized official:** MR. ALULA BEKELE BERHANE (OWNER/PARTNER)
- **Authorized official phone:** (310) 714-9667

## Contact information

- **Practice address:** 1704 W MANCHESTER AVE, SUITE 204D, LOS ANGELES, CA 90047-3034
- **Practice address phone:** (323) 758-7550
- **Practice address fax:** (323) 758-5550
- **Mailing address:** 1704 W MANCHESTER AVE, SUITE 204D, LOS ANGELES, CA 90047-3034
- **Mailing address phone:** (323) 758-7550
- **Mailing address fax:** (323) 758-5550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 103338 | CA | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 07/21/2022