Organization
PROMED SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETROS PATATANIAN (PRESIDENT)
(818) 616-4348
Entity
Organization
Contact information
Practice address
16045 SHERMAN WAY STE C, VAN NUYS, CA 91406-4085
(818) 616-4348
(818) 616-4134
Mailing address
16045 SHERMAN WAY STE C, VAN NUYS, CA 91406-4085
(818) 616-4348
(818) 616-4134
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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