Organization
COLGATE MEDICAL AND SURGICAL SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LANA KAGANOVSKY (PRESIDENT)
(323) 782-0145
Entity
Organization
Contact information
Practice address
425 S FAIRFAX AVE STE 209, LOS ANGELES, CA 90036-3148
(323) 782-0145
(323) 782-0273
Mailing address
425 S FAIRFAX AVE STE 209, LOS ANGELES, CA 90036-3148
(323) 782-0145
(323) 782-0273
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
52093
CA
332BX2000X
Oxygen Equipment & Supplies (DME)
52093
CA
335E00000X
Prosthetic/Orthotic Supplier
52093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0443540001
MEDICARE PTAN
CA
01
—
52093
HMDR LICENSE
CA
01
—
M120227
FURNITURE & BEDDING RETAI
CA
Enumeration date
05/07/2007
Last updated
01/11/2024
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