Organization
MARTIN LUTHER VOCATIONAL CENTER, INC
Active
Other names
LA Medical Store LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAULINUS NDIBE (CEO)
(626) 639-3975
Entity
Organization
Contact information
Practice address
428 S ROSEMEAD BLVD, PASADENA, CA 91107
(626) 639-3875
(626) 639-3975
Mailing address
428 S ROSEMEAD BLVD, PASADENA, CA 91107
(626) 639-3975
(626) 639-3975
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
335G00000X
Medical Foods Supplier
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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