# GRACE EBENUWA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Alfa Medical Equipment Depot and Support
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871756114
- **Authorized official:** MS. GRACE EBENUWA RN (OWNER)
- **Authorized official phone:** (323) 293-3983

## Contact information

- **Practice address:** 2521 W SLAUSON AVE, LOS ANGELES, CA 90043-3248
- **Practice address phone:** (323) 293-3983
- **Practice address fax:** (323) 293-3965
- **Mailing address:** 2521 W SLAUSON AVE, LOS ANGELES, CA 90043-3248
- **Mailing address phone:** (323) 293-3983
- **Mailing address fax:** (323) 293-3965

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 49545 | CA | Yes |

## Other

- **Enumeration date:** 07/07/2008
- **Last updated:** 07/07/2008