Provider Demographics
NPI:1225199862
Name:HOPE MEDICAL SUPPLY,LLC.
Entity Type:Organization
Organization Name:HOPE MEDICAL SUPPLY,LLC.
Other - Org Name:HOPE MEDICAL SUPPLY, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AIDERUS
Authorized Official - Middle Name:IBRAHIM
Authorized Official - Last Name:SHERIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-671-3728
Mailing Address - Street 1:237 E QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1719
Mailing Address - Country:US
Mailing Address - Phone:310-671-3728
Mailing Address - Fax:310-671-3763
Practice Address - Street 1:237 E QUEEN ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1719
Practice Address - Country:US
Practice Address - Phone:310-671-3728
Practice Address - Fax:310-671-3763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4771520001Medicare ID - Type Unspecified