Provider Demographics
NPI:1376572016
Name:A&K MEDICAL SUPPLY
Entity Type:Organization
Organization Name:A&K MEDICAL SUPPLY
Other - Org Name:A&K MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KAHREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOKSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-904-2645
Mailing Address - Street 1:13735 VICTORY BLVB
Mailing Address - Street 2:#7
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-2300
Mailing Address - Country:US
Mailing Address - Phone:818-904-2645
Mailing Address - Fax:818-904-2745
Practice Address - Street 1:13735 VICTORY BLVB
Practice Address - Street 2:#7
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-2300
Practice Address - Country:US
Practice Address - Phone:818-904-2645
Practice Address - Fax:818-904-2745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA715231-80332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4621180001Medicare NSC