Provider Demographics
NPI:1427369909
Name:V & J MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:V & J MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:SALVADOR
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:323-947-7547
Mailing Address - Street 1:8330 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-2073
Mailing Address - Country:US
Mailing Address - Phone:323-947-7547
Mailing Address - Fax:323-973-1733
Practice Address - Street 1:8330 LONG BEACH BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-2073
Practice Address - Country:US
Practice Address - Phone:323-947-7547
Practice Address - Fax:323-973-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies