Organization
BLAKE HEALTH MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ONYEBUCHI BLAKE AGBU (PRESIDENT)
(805) 445-1013
Entity
Organization
Contact information
Practice address
4956 VERDUGO WAY, SUITE 1, CAMARILLO, CA 93012-8632
(805) 445-1013
(805) 445-4526
Mailing address
4956 VERDUGO WAY, SUITE 1, CAMARILLO, CA 93012-8632
(805) 445-1013
(805) 445-4526
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
53425
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101436649
CALIFORNIA SELLER'S PERMIT
CA
Enumeration date
02/25/2010
Last updated
07/28/2010
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