# INDEPENDENT LIFE MEDICAL SUPPLIES

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

## Provider details

- **NPI number:** 1720254311
- **Authorized official:** MR. ROWEN EDWARD NAIDOO (OFFICER)
- **Authorized official phone:** (510) 868-2185

## Contact information

- **Practice address:** 2036 BLAKE ST, BERKELEY, CA 94704-2604
- **Practice address phone:** (510) 868-2185
- **Practice address fax:** (510) 263-6040
- **Mailing address:** 2036 BLAKE ST, BERKELEY, CA 94704-2604
- **Mailing address phone:** (510) 868-2185
- **Mailing address fax:** (510) 263-6040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 200808410268 | CA | Yes |

## Other

- **Enumeration date:** 05/02/2008
- **Last updated:** 02/04/2014