Provider Demographics
NPI:1164602876
Name:HEALTHVIEW MEDICAL SUPPLY
Entity Type:Organization
Organization Name:HEALTHVIEW MEDICAL SUPPLY
Other - Org Name:HEALTHVIEW MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:KANAYO
Authorized Official - Last Name:AGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-522-3982
Mailing Address - Street 1:3711 LONG BEACH BLVD.
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3319
Mailing Address - Country:US
Mailing Address - Phone:562-426-3659
Mailing Address - Fax:562-492-1206
Practice Address - Street 1:3711 LONG BEACH BLVD.
Practice Address - Street 2:SUITE 214
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3319
Practice Address - Country:US
Practice Address - Phone:562-426-3659
Practice Address - Fax:562-492-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44820332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03398FMedicaid
CADME03398FMedicaid