Provider Demographics
NPI:1164652038
Name:NADIFA MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:NADIFA MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAKWENZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-419-2966
Mailing Address - Street 1:314 E HILLCREST BLVD
Mailing Address - Street 2:STE 4
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-2423
Mailing Address - Country:US
Mailing Address - Phone:310-419-2966
Mailing Address - Fax:310-419-2969
Practice Address - Street 1:314 E HILLCREST BLVD
Practice Address - Street 2:STE 4
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-2423
Practice Address - Country:US
Practice Address - Phone:310-419-2966
Practice Address - Fax:310-419-2969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies