Organization
DIVINE MEDICAL SUPPLY, INCORPORATED
Active
Organization
DIVINE MEDICAL SUPPLY, INCORPORATED
Active
Other names
Divine Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FEMI O ABATAN (PRESIDENT)
(714) 225-4762
Entity
Organization
Contact information
Practice address
285 S GILBERT ST, FULLERTON, CA 92833-2908
(714) 457-2049
(714) 930-9435
Mailing address
285 S GILBERT ST, FULLERTON, CA 92833-2908
(714) 457-2049
(714) 930-9435
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
—
—
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
Other
Enumeration date
04/23/2011
Last updated
04/23/2011
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