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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
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