ANGELES VISTA MEDICAL SUPPLIES (NPI# 1417041112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417041112 |
| Entity Type | Organization |
| Organization Name | ANGELES VISTA MEDICAL SUPPLIES |
| Practice Address |
11929 Los Nietos Road Santa Fe Springs CA 90670-2527 |
| Practice Telephone | 5626997200 |
| Practice Fax Number | 5626997210 |
| Mailing Telephone | 5626997200 |
| Mailing Fax Number | 5626997210 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-08-31 |
| Authorized Official Name | MR. MARKSON BOLA ALABI (SOLE-PROPRIETOR) |
| Authorized Official Telephone | 5626997200 |
| Authorized Official Credential | CO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
DME02177F | CA | Suppliers |
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
DME02177F | CA | Suppliers |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | DME02177F | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DME02177F | 05 |
| Street Address |
11929 LOS NIETOS ROAD |
| City | SANTA FE SPRINGS |
| State | CA |
| Zip Code | 90670-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283279 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 11721 East Telegraph Road Unit I, Santa Fe Springs, CA 90670 | 2020-04-13 |
| 1487205563 | Jurrell Davis | Counselor | 16332 Marvene Dr., Santa Fe Springs, CA 90670 | 2019-09-20 |
| 1003370065 | Amber D Perez-riggins | Counselor | 11015 Bloomfiled Ave, Santa Fe Springs, CA 90670 | 2019-01-24 |
| 1154832749 | Los Angeles Center for Alcohol and Drug Abuse | Clinic/Center | 12580 Lakeland Road, Santa Fe Springs, CA 90670 | 2017-10-23 |
| 1518481001 | Cecilia Bueno | Case Manager/Care Coordinator | 11721 Telegraph Rd, Santa Fe Springs, CA 90670 | 2017-07-27 |
| 1447773148 | Richard Paige | Counselor | 10425 S. Painter Ave., Santa Fe Springs, CA 90670 | 2017-07-25 |
| 1326578709 | Mariah Patricia Ramirez | Counselor | 11741 Telegraph Rd Ste A-d, Santa Fe Springs, CA 90670 | 2017-06-18 |
| 1578947446 | Robynn Coleman | In Home Supportive Care | 10510 Maple Lane, Santa Fe Springs, CA 90670 | 2015-07-10 |
| 1003218314 | Norma Gonzalez | Case Manager/Care Coordinator | 11741 E. Telegraph Road, Santa Fe Springs, CA 90670 | 2014-09-17 |
| 1932510617 | Antonio Matinez Sr. | Rehabilitation Practitioner | 10012 Norwalk Blvd Suite 140, Santa Fe Springs, CA 90670 | 2014-05-15 |
| Find all providers in zip 90670 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283279 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 11721 East Telegraph Road Unit I, Santa Fe Springs, CA 90670 | 2020-04-13 |
| 1124367487 | Seven Seas Distribution and Manufacturing | Durable Medical Equipment & Medical Supplies | 11643 Telegraph Rd Ste 200, Santa Fe Springs, CA 90670-3680 | 2013-02-06 |
| 1346443454 | Progressive Orthopedic Solutions | Durable Medical Equipment & Medical Supplies | 11643 Telegraph Rd, Santa Fe Springs, CA 90670-3680 | 2007-06-06 |
| 1245389162 | Marknew Products Corp | Durable Medical Equipment & Medical Supplies | 14140 Firestone Blvd, Santa Fe Springs, CA 90670-5810 | 2007-01-09 |
| 1184798084 | Seungbum Bak | Durable Medical Equipment & Medical Supplies | 14535 Valley View Ave Ste L, Santa Fe Springs, CA 90670-5234 | 2006-11-20 |
| 1003988676 | Elixair Medical Inc. | Durable Medical Equipment & Medical Supplies | 12035 Burke St Ste 13, Santa Fe Springs, CA 90670-8633 | 2006-11-15 |
| 1811069065 | Montgomery Marketing | Durable Medical Equipment & Medical Supplies | 12319 Telegraph Rd, Santa Fe Springs, CA 90670 | 2006-11-14 |
| 1730267618 | Matix Diabetic, Inc | Durable Medical Equipment & Medical Supplies | 14111 Freeway Dr # 303, Santa Fe Springs, CA 90670-5822 | 2006-11-01 |
| 1316051337 | Shield California Health Care Center Inc | Durable Medical Equipment & Medical Supplies | 9520 Norwalk Blvd, Santa Fe Springs, CA 90670-2930 | 2006-08-18 |
| 1003839390 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 10621 Carmenita Rd, Santa Fe Springs, CA 90670-4017 | 2006-07-26 |
| Find all providers in SANTA FE SPRINGS | ||||
| City | SANTA FE SPRINGS |
| Zip Code | 90670 |
Please comment or provide details below to improve the information on ANGELES VISTA MEDICAL SUPPLIES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.