Provider Demographics
NPI:1407051618
Name:DONALD N IWUAGWU
Entity Type:Organization
Organization Name:DONALD N IWUAGWU
Other - Org Name:NADONAH MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:NNAMDI
Authorized Official - Last Name:IWUAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-718-3870
Mailing Address - Street 1:5021 COLUMBIA WAY
Mailing Address - Street 2:
Mailing Address - City:QUARTZ HILL
Mailing Address - State:CA
Mailing Address - Zip Code:93536-3010
Mailing Address - Country:US
Mailing Address - Phone:661-718-3870
Mailing Address - Fax:
Practice Address - Street 1:5021 COLUMBIA WAY
Practice Address - Street 2:
Practice Address - City:QUARTZ HILL
Practice Address - State:CA
Practice Address - Zip Code:93536-3010
Practice Address - Country:US
Practice Address - Phone:661-718-3870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47180332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA41780OtherHMDR