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Organization
MARTIN LUTHER VOCATIONAL CENTER, INC
Active
Organization
MARTIN LUTHER VOCATIONAL CENTER, INC
Active
Other names
LA Medical Store LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAULINUS NDIBE (CEO)
(626) 639-3975
Entity
Organization
Contact information
Practice address
428 S ROSEMEAD BLVD, PASADENA, CA 91107
(626) 639-3875
(626) 639-3975
Mailing address
428 S ROSEMEAD BLVD, PASADENA, CA 91107
(626) 639-3975
(626) 639-3975
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
335E00000X
Prosthetic/Orthotic Supplier
—
NULL
335G00000X
Medical Foods Supplier
—
NULL
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
NULL
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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