Organization
AVASCO MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY ABABSEH (PRESIDENT)
(805) 522-5333
Entity
Organization
Contact information
Practice address
4268 E LOS ANGELES AVE, SUITE #102, SIMI VALLEY, CA 93063-3366
(805) 522-5333
(805) 522-6333
Mailing address
4268 E LOS ANGELES AVE, SUITE #102, SIMI VALLEY, CA 93063-3366
(805) 522-5333
(805) 522-6333
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0002402171-0001-2
CA
332BX2000X
Oxygen Equipment & Supplies (DME)
51170
CA
335E00000X
Prosthetic/Orthotic Supplier
0002402171-0001-2
CA
Other
Enumeration date
05/06/2010
Last updated
11/10/2015
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