Organization
STAT HOMEHEALTH MEDICAL SUPPLY, LLC.
Active
Other names
STAT Homehealth Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NIKO OGANESIAN RCP (PRESIDENT)
(562) 622-1002
Entity
Organization
Contact information
Practice address
11411 BROOKSHIRE AVE, SUITE 505, DOWNEY, CA 90241-5003
(562) 622-1002
(562) 622-1058
Mailing address
11411 BROOKSHIRE AVE, SUITE 505, DOWNEY, CA 90241-5003
(562) 622-1002
(562) 622-1058
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
47463
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47463
DEPT. OF PUBLIC HEALTH
CA
Enumeration date
08/08/2007
Last updated
08/08/2007
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