Organization
PIONEER MEDICAL SUPPLY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN AGHA OFFOR (MANAGING DIRECTOR)
(323) 778-3815
Entity
Organization
Contact information
Practice address
8221 S WESTERN AVE, LOS ANGELES, CA 90047-3036
(323) 778-3815
(323) 778-3819
Mailing address
PO BOX 451155, LOS ANGELES, CA 90045-8511
(323) 778-3815
(323) 778-3819
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
103149
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03188F
—
CA
Enumeration date
05/02/2006
Last updated
11/13/2007
Update your record
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