KNC MEDICAL SUPPLY, INC (NPI# 1578595641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578595641 |
| Entity Type | Organization |
| Organization Name | KNC MEDICAL SUPPLY, INC |
| Practice Address |
3819 W Slauson Ave Ste H Los Angeles CA 90043-2970 |
| Mailing Address |
4718 S Mullen Ave Los Angeles CA 90043-1718 |
| Practice Telephone | 3232990837 |
| Practice Fax Number | 3232990839 |
| Mailing Telephone | 3232990837 |
| Mailing Fax Number | 3232990839 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-04-19 |
| Authorized Official Name | MR. OKEY OKAFOR (MANAGING DIRECTOR) |
| Authorized Official Telephone | 3232990837 |
| Authorized Official Credential | N/A |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
DME03143G | CA | Suppliers |
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
DME03143G | CA | Suppliers |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | DME03143G | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DME03143G | 05 |
| Street Address |
3819 W SLAUSON AVE STE H |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90043-2970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841772209 | Ichizo Yamada | Counselor | 5318 S Crenshaw Blvd., Los Angeles, CA 90043 | 2018-09-02 |
| 1568961613 | Marnelle Mascardo | Counselor | 5318 S. Crenshaw Blvd., Los Angeles, CA 90043 | 2018-02-05 |
| 1700315199 | Positive Imagery Foundation | Prevention Professional | 5906 7th Avenue, Suite 1, Los Angeles, CA 90043 | 2017-06-08 |
| 1770946303 | Toby Lapesarde | Licensed Vocational Nurse | 5300 Angeles Vista Boulevard, Los Angeles, CA 90043 | 2016-03-31 |
| 1134591480 | Coast Wise Solution | Case Management | 2728 54th St, Los Angeles, CA 90043 | 2015-10-27 |
| 1033589155 | Nina Gonzaga | Marriage & Family Therapist | 4401 Crendshaw Blvd, #300, Los Angeles, CA 90043 | 2015-10-01 |
| 1861743189 | Donna M. Tizenor-tate | Counselor | 5300 Angeles Vista Blvd., Los Angeles, CA 90043 | 2012-09-26 |
| 1952657736 | Willie Frank Sibley Jr. | General Practice | 4330 Monteith Dr, Los Angeles, CA 90043 | 2012-07-30 |
| 1639449119 | Nelson M Okeke | Counselor | 8814 S. Western Ave, La, CA 90043 | 2011-12-30 |
| 1578840799 | Economic Services, Incorporated | Exclusive Provider Organization | 5144 Crenshaw Blvd., Los Angeles, CA 90043 | 2011-11-16 |
| Find all providers in zip 90043 | ||||
| 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 |
|---|---|---|---|---|
| 1700484219 | Oa Medicals LLC | Durable Medical Equipment & Medical Supplies | 1704 W Manchester Ave Ste 203, Los Angeles, CA 90047-3057 | 2020-10-16 |
| 1598376790 | Supercare Depot Inc | Durable Medical Equipment & Medical Supplies | 11901 Santa Monica Blvd Ste 470, Los Angeles, CA 90025-2767 | 2020-08-11 |
| 1568089548 | Dmg Wellness Inc. | Durable Medical Equipment & Medical Supplies | 2651 Nevin Ave, Los Angeles, CA 90011-2242 | 2020-06-25 |
| 1467073098 | Revive Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 232 E 2nd St Apt 752, Los Angeles, CA 90012-4539 | 2020-05-05 |
| 1558993527 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5500 West Sunset Boulevard, Los Angeles, CA 90028 | 2020-02-07 |
| 1386276400 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 8900 S Sepulveda Blvd, Los Angeles, CA 90045-3604 | 2020-02-06 |
| 1366074676 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 415 S La Brea Ave, Los Angeles, CA 90036-3523 | 2020-02-05 |
| 1689214744 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 555 N Broadway # B101, Los Angeles, CA 90012-4700 | 2020-01-07 |
| 1548816291 | Cath Dry, Inc. | Durable Medical Equipment & Medical Supplies | 1243 N Hoover St, Los Angeles, CA 90029-2009 | 2019-08-16 |
| 1386299139 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1302 South La Brea, Los Angeles, CA 90019 | 2019-08-08 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90043 |
Please comment or provide details below to improve the information on KNC MEDICAL SUPPLY, INC.
| 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.