Provider Demographics
NPI:1275758591
Name:P & R MEDICAL INC.
Entity Type:Organization
Organization Name:P & R MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIGITTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUREKHOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-654-9779
Mailing Address - Street 1:7860 SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5313
Mailing Address - Country:US
Mailing Address - Phone:323-654-9779
Mailing Address - Fax:323-654-7865
Practice Address - Street 1:7860 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5313
Practice Address - Country:US
Practice Address - Phone:323-654-9779
Practice Address - Fax:323-654-7865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16820 102165332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1191230001Medicare ID - Type Unspecified