Provider Demographics
NPI:1114175932
Name:SOKAB MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:SOKAB MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUSOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-804-4076
Mailing Address - Street 1:2130 N ARROWHEAD AVE
Mailing Address - Street 2:103A
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4023
Mailing Address - Country:US
Mailing Address - Phone:909-804-4076
Mailing Address - Fax:909-804-4078
Practice Address - Street 1:2130 N ARROWHEAD AVE
Practice Address - Street 2:103 A
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4023
Practice Address - Country:US
Practice Address - Phone:909-804-4076
Practice Address - Fax:909-804-4078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33200000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies