Organization
ITC MEDICAL SUPPLIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAINA KAUTSKY (VICE PRESIDENT)
(415) 346-7100
Entity
Organization
Contact information
Practice address
1635 DIVISADERO ST STE 105, SAN FRANCISCO, CA 94115-3000
(415) 346-7100
(415) 346-7177
Mailing address
1635 DIVISADERO ST STE 105, SAN FRANCISCO, CA 94115-3000
(415) 346-7100
(415) 346-7177
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
197039600
DEPT OF LABOR
CA
05
—
DME01988F
—
CA
Enumeration date
09/12/2006
Last updated
11/14/2014
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