Organization
QUEEN OF ANGELS MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHRIST KAKOSIMIDI (CEO)
(818) 760-2156
Entity
Organization
Contact information
Practice address
12154 HAMLIN ST, NORTH HOLLYWOOD, CA 91606-1409
(818) 760-2156
(818) 942-7059
Mailing address
12154 HAMLIN ST, NORTH HOLLYWOOD, CA 91606-1409
(818) 760-2156
(818) 942-7059
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487685137
—
CA
Enumeration date
10/25/2018
Last updated
12/29/2023
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