Provider Demographics
NPI:1033277520
Name:SAMSUNG MEDICAL SUPPLIES USA CORP.
Entity Type:Organization
Organization Name:SAMSUNG MEDICAL SUPPLIES USA CORP.
Other - Org Name:SAMSUNG MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BUMI
Authorized Official - Middle Name:T
Authorized Official - Last Name:RYU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-388-8230
Mailing Address - Street 1:2727 W OLYMPIC BLVD
Mailing Address - Street 2:112
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2637
Mailing Address - Country:US
Mailing Address - Phone:213-388-8230
Mailing Address - Fax:213-388-8678
Practice Address - Street 1:2727 W OLYMPIC BLVD
Practice Address - Street 2:112
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2637
Practice Address - Country:US
Practice Address - Phone:213-388-8230
Practice Address - Fax:213-388-8678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6117880001Medicare NSC