Provider Demographics
NPI:1255505889
Name:MORRIS MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:MORRIS MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-533-8338
Mailing Address - Street 1:1842 LINCOLN AVE.
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5489
Mailing Address - Country:US
Mailing Address - Phone:714-533-8338
Mailing Address - Fax:714-533-8589
Practice Address - Street 1:1842 LINCOLN AVE.
Practice Address - Street 2:SUITE A
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5489
Practice Address - Country:US
Practice Address - Phone:714-533-8338
Practice Address - Fax:714-533-8589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49269332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6119910001Medicare NSC