Provider Demographics
NPI:1427036201
Name:TWINS MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:TWINS MEDICAL SUPPLY LLC
Other - Org Name:TWINS MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FIDELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NNAMDI-OBINMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-601-7138
Mailing Address - Street 1:1571 N E ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4510
Mailing Address - Country:US
Mailing Address - Phone:909-601-7168
Mailing Address - Fax:909-601-7140
Practice Address - Street 1:1571 N E ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4510
Practice Address - Country:US
Practice Address - Phone:909-601-7138
Practice Address - Fax:909-601-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4813770001Medicare ID - Type Unspecified