Provider Demographics
NPI:1346422649
Name:INTERNATIONAL MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:INTERNATIONAL MEDICAL SUPPLY, INC
Other - Org Name:INTERNATIONAL MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAKOP
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-994-6713
Mailing Address - Street 1:14355 VICTORY BLVD
Mailing Address - Street 2:UNIT B
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6526
Mailing Address - Country:US
Mailing Address - Phone:818-994-6713
Mailing Address - Fax:818-994-9333
Practice Address - Street 1:14355 VICTORY BLVD
Practice Address - Street 2:UNIT B
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6526
Practice Address - Country:US
Practice Address - Phone:818-994-6713
Practice Address - Fax:818-994-9333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies