Organization
EDEN GARDEN WEST, INC. MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM C NWOSU (OWNER)
(310) 330-8200
Entity
Organization
Contact information
Practice address
659 S LA BREA AVE, INGLEWOOD, CA 90301-2725
(310) 330-8200
(310) 330-8344
Mailing address
659 S LA BREA AVE, INGLEWOOD, CA 90301-2725
(310) 330-8200
(310) 330-8344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
44634
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44634
HMDR
CA
Enumeration date
01/10/2007
Last updated
08/22/2020
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