Organization
BROADWAY MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN O OSIOH (OWNER)
(323) 752-7831
Entity
Organization
Contact information
Practice address
8512 S BROADWAY, LOS ANGELES, CA 90003-3335
(323) 752-7831
Mailing address
PO BOX 73571, LOS ANGELES, CA 90003-0571
(323) 752-7831
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Enumeration date
03/24/2008
Last updated
12/15/2010
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