Organization
CRAFT WHEELCHAIR REPAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAY C MOORE (PRESIDENT)
(323) 931-6164
Entity
Organization
Contact information
Practice address
4077 W PICO BLVD STE D, LOS ANGELES, CA 90019-4308
(323) 931-6164
(323) 931-2907
Mailing address
4077 W PICO BLVD STE D, LOS ANGELES, CA 90019-4308
(323) 931-6164
(323) 931-2907
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME01583G
—
CA
Enumeration date
08/09/2006
Last updated
08/01/2024
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