Provider Demographics
NPI:1336317403
Name:NKEM IHEANAJU
Entity Type:Organization
Organization Name:NKEM IHEANAJU
Other - Org Name:GLOBAL COMMERCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NKEM
Authorized Official - Middle Name:
Authorized Official - Last Name:IHEANAJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-221-5310
Mailing Address - Street 1:PO BOX 1541
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90251-1541
Mailing Address - Country:US
Mailing Address - Phone:310-221-5310
Mailing Address - Fax:310-834-6119
Practice Address - Street 1:1300 E 223RD ST
Practice Address - Street 2:SUITE 407
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-4355
Practice Address - Country:US
Practice Address - Phone:310-221-5310
Practice Address - Fax:310-834-6119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103335332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4098020003Medicare NSC