# FUNDAMENTAL MEDICAL SUPPLY INC

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

## Provider details

- **NPI number:** 1740086198
- **Authorized official:** GRIGORY ATKOZYAN (CEO)
- **Authorized official phone:** (805) 230-2220

## Contact information

- **Practice address:** 7325 RESEDA BLVD, RESEDA, CA 91335-3048
- **Practice address phone:** (805) 230-2220
- **Mailing address:** 7114 RESEDA BLVD, RESEDA, CA 91335-4210
- **Mailing address phone:** (805) 230-2220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 02/24/2025
- **Last updated:** 04/17/2026