Organization
GUSTINO MEDICAL SUPPLY CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AUGUSTINE OKON UWAH (OWNER)
(310) 523-2123
Entity
Organization
Contact information
Practice address
13998 CRENSHAW BLVD, GARDENA, CA 90249-2714
(310) 523-2123
(310) 523-2192
Mailing address
13998 CRENSHAW BLVD, P.O. BOX 1588, GARDENA, CA 90249-2714
(310) 523-2123
(310) 523-2192
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
102504
CA
Other
Enumeration date
11/03/2005
Last updated
08/12/2008
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