Provider Demographics
NPI:1417032319
Name:MARINA AKOPIAN
Entity Type:Organization
Organization Name:MARINA AKOPIAN
Other - Org Name:MEDICAL SUPPLY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKOPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-465-4500
Mailing Address - Street 1:5301 W SUNSET BLVD
Mailing Address - Street 2:#1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5694
Mailing Address - Country:US
Mailing Address - Phone:323-465-4500
Mailing Address - Fax:323-469-4900
Practice Address - Street 1:5301 W SUNSET BLVD
Practice Address - Street 2:#1
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5694
Practice Address - Country:US
Practice Address - Phone:323-465-4500
Practice Address - Fax:323-469-4900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME01788FMedicaid
CA0729990001Medicare NSC