Organization
LORD'S MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
O. TEMITOPE ANIFOWOSE (OWNER)
(310) 324-0516
Entity
Organization
Contact information
Practice address
1552 W 139TH ST, SUITE E, GARDENA, CA 90249-2642
(310) 324-0516
(310) 324-0518
Mailing address
1552 W 139TH STREET, SUITE E, GARDENA, CA 90249-2642
(310) 324-0516
(310) 324-0518
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
103477
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03219F
—
CA
Enumeration date
08/24/2006
Last updated
08/22/2020
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