Provider Demographics
NPI:1043235724
Name:AMERICAN GLOBAL MEDICAL SUPPLIES INC,
Entity Type:Organization
Organization Name:AMERICAN GLOBAL MEDICAL SUPPLIES INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALASHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-241-5241
Mailing Address - Street 1:434 W COLORADO ST
Mailing Address - Street 2:101
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-3081
Mailing Address - Country:US
Mailing Address - Phone:818-241-5241
Mailing Address - Fax:818-241-5249
Practice Address - Street 1:434 W COLORADO ST
Practice Address - Street 2:101
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-3081
Practice Address - Country:US
Practice Address - Phone:818-241-5241
Practice Address - Fax:818-241-5249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5737290001Medicare NSC