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Organization

HARRISON M IRIAFEN

Active
Other names
GOOD SHEPARD MEDICAL SUPPLY
Organization subpart
No

Provider details

NPI number
Authorized official
HARRISON M IRIAFEN (OWNER)
(818) 785-3584
Entity
Organization

Contact information

Practice address
14640 VICTORY BLVD, SUITE 205, VAN NUYS, CA 91411-1623
(818) 785-3584
(818) 785-7910
Mailing address
14640 VICTORY BLVD, SUITE 205, VAN NUYS, CA 91411-1623
(818) 785-3584
(818) 785-7910

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DME03397F
CA
Enumeration date
11/13/2007
Last updated
06/17/2008
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