# ITC MEDICAL SUPPLIES INC

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

## Provider details

- **NPI number:** 1780012237
- **Authorized official:** MRS. FAINA KAUTSKY (VICE PRESIDENT)
- **Authorized official phone:** (415) 387-7100

## Contact information

- **Practice address:** 1635 DIVISADERO ST, SUITE 105, SAN FRANCISCO, CA 94115-3036
- **Practice address phone:** (415) 346-7100
- **Practice address fax:** (415) 346-7177
- **Mailing address:** 1635 DIVISADERO ST, SUITE 105, SAN FRANCISCO, CA 94115-3036
- **Mailing address phone:** (415) 346-7100
- **Mailing address fax:** (415) 346-7177

## 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:** 10/19/2013
- **Last updated:** 10/19/2013