Provider Demographics
NPI:1427373133
Name:FLASH MEDICAL SUPPLY & HEALTHCARE, INC.
Entity Type:Organization
Organization Name:FLASH MEDICAL SUPPLY & HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCOUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-973-3304
Mailing Address - Street 1:15424 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2153
Mailing Address - Country:US
Mailing Address - Phone:310-973-3304
Mailing Address - Fax:310-973-3305
Practice Address - Street 1:15424 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2153
Practice Address - Country:US
Practice Address - Phone:310-973-3304
Practice Address - Fax:310-973-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51167332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6460250001Medicare NSC