Organization
EASTSIDE MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIANA GRIGORYAN (CEO)
(661) 272-0004
Entity
Organization
Contact information
Practice address
2720 E PALMDALE BLVD, SUITE 124, PALMDALE, CA 93550-4930
(661) 272-0004
Mailing address
2720 E PALMDALE BLVD, SUITE 124, PALMDALE, CA 93550-4930
(661) 272-0004
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/02/2011
Last updated
12/23/2011
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