Organization
ITC MEDICAL SUPPLIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAINA KAUTSKY (VICE PRESIDENT)
(415) 387-7100
Entity
Organization
Contact information
Practice address
4373 GEARY BLVD, SAN FRANCISCO, CA 94118-3003
(415) 387-7100
(415) 387-2540
Mailing address
4373 GEARY BLVD, SAN FRANCISCO, CA 94118-3003
(415) 387-7100
(415) 387-2540
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME02141F
—
CA
01
—
ZZZ35120Z
BLUE SHIELD OF CA
—
Enumeration date
09/08/2006
Last updated
09/11/2025
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