Organization
PRESTIGE ENTERPRISE A MEDICAL SUPPLY CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GODFREY U. NWOGENE (PRESIDENT)
(310) 515-0979
Entity
Organization
Contact information
Practice address
1113 W GARDENA BLVD, SUITE A, GARDENA, CA 90247-4887
(310) 515-0979
(310) 515-1290
Mailing address
1113 W GARDENA BLVD, SUITE A, GARDENA, CA 90247-4887
(310) 515-0979
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332B0000X
CA
Other
Enumeration date
08/15/2006
Last updated
10/29/2008
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