Provider Demographics
NPI:1417028572
Name:MAGNET MEDICAL SUPPLY INC.
Entity Type:Organization
Organization Name:MAGNET MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NWANNEKA
Authorized Official - Middle Name:UCHE
Authorized Official - Last Name:AZUBUIKE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:310-217-1484
Mailing Address - Street 1:14618 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-3147
Mailing Address - Country:US
Mailing Address - Phone:310-736-7565
Mailing Address - Fax:310-217-1463
Practice Address - Street 1:14618 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-3147
Practice Address - Country:US
Practice Address - Phone:310-736-7565
Practice Address - Fax:310-217-1463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46164332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA46164OtherSUPPLIER OF DME