Organization
I&M GRAND MEDICAL SUPPLIES
Active
Other names
IVAN MANUCHARYAN
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVAN MANUCHARYAN (OWNER)
(623) 934-3752
Entity
Organization
Contact information
Practice address
5826 W OLIVE AVE STE 102, GLENDALE, AZ 85302-3153
(623) 934-3752
(623) 934-3725
Mailing address
5826 W OLIVE AVE STE 102, GLENDALE, AZ 85302-3153
(623) 934-3752
(623) 934-3725
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
20174034
AZ
Other
Enumeration date
07/24/2007
Last updated
08/01/2007
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