Organization
AGOMO HOME MEDICAL SUPPLIES, INC.
Active
Other names
AGOMO HOME MEDICAL SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS PONCE (PRESIDENT)
(562) 704-6190
Entity
Organization
Contact information
Practice address
10638 BURBANK BLVD, NORTH HOLLYWOOD, CA 91601-2511
(818) 985-1753
(818) 985-1593
Mailing address
10638 BURBANK BLVD, NORTH HOLLYWOOD, CA 91601
(818) 985-1753
(818) 985-1593
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
55075
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03157F
—
CA
Enumeration date
05/20/2006
Last updated
09/29/2011
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