Provider Demographics
NPI:1346250404
Name:CONFIDENCE FIRST MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:CONFIDENCE FIRST MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-330-7636
Mailing Address - Street 1:5811 HOLT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-1411
Mailing Address - Country:US
Mailing Address - Phone:310-670-9670
Mailing Address - Fax:
Practice Address - Street 1:316 E MANCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1815
Practice Address - Country:US
Practice Address - Phone:310-330-7636
Practice Address - Fax:310-330-7635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACGP163747OtherCCS
CADME02579FMedicaid
ZZZ66603ZOtherBL SHIELD TRICARE
1210400001Medicare ID - Type Unspecified