Organization
LILY MEDICAL EQUIPMENT SUPPLIER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BRUKTAWIT DEMREW (PRESIDENT)
(323) 261-3729
Entity
Organization
Contact information
Practice address
2099 S ATLANTIC BLVD, UNIT O, MONTEREY PARK, CA 91754-6355
(323) 261-3729
(323) 261-3719
Mailing address
2099 S ATLANTIC BLVD, UNIT O, MONTEREY PARK, CA 91754-6355
(323) 261-3729
(323) 261-3719
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
47296
CA
Other
Enumeration date
06/12/2007
Last updated
03/03/2008
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