# LACRESCENTA MEDICAL SUPPLY

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

## Provider details

- **NPI number:** 1982638144
- **Authorized official:** ANNA SHARYAN (OWNER)
- **Authorized official phone:** (818) 542-9800

## Contact information

- **Practice address:** 3131 FOOTHILL BLVD STE G, LA CRESCENTA, CA 91214-4229
- **Practice address phone:** (818) 542-9800
- **Practice address fax:** (818) 542-9830
- **Mailing address:** 3131 FOOTHILL BLVD STE G, LA CRESCENTA, CA 91214-4229
- **Mailing address phone:** (818) 542-9800
- **Mailing address fax:** (818) 542-9830

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 101418 | CA | Yes |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 09/19/2007