# PRUDENT MEDICAL SUPPLIES INC

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

## Provider details

- **NPI number:** 1770954471
- **Authorized official:** MR. BRUCK MENGISTU (PRESIDENT)
- **Authorized official phone:** (424) 331-5400

## Contact information

- **Practice address:** 5250 W CENTURY BLVD, SUITE 216, LOS ANGELES, CA 90045-5972
- **Practice address phone:** (424) 331-5400
- **Practice address fax:** (424) 331-5933
- **Mailing address:** 5250 W CENTURY BLVD, SUITE 216, LOS ANGELES, CA 90045-5972
- **Mailing address phone:** (424) 331-5400
- **Mailing address fax:** (424) 331-5933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 74463 | CA | Yes |

## Other

- **Enumeration date:** 10/07/2015
- **Last updated:** 04/19/2017