# TOLUCA LAKE MEDICAL SUPPLY INC

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

## Provider details

- **NPI number:** 1962684688
- **Authorized official:** MS. KARINE KASABYAN (PRESIDENT)
- **Authorized official phone:** (818) 980-6611

## Contact information

- **Practice address:** 4510 FORMAN AVE, TOLUCA LAKE, CA 91602-1615
- **Practice address phone:** (818) 980-6611
- **Practice address fax:** (818) 980-6621
- **Mailing address:** 4510 FORMAN AVE, TOLUCA LAKE, CA 91602-1615
- **Mailing address phone:** (818) 980-6611
- **Mailing address fax:** (818) 980-6621

## Taxonomy

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

## Other

- **Enumeration date:** 12/04/2007
- **Last updated:** 12/29/2008