Provider Demographics
NPI:1497089023
Name:OK MEDICAL EQUIPMENTS AND SUPPLY, LLC
Entity Type:Organization
Organization Name:OK MEDICAL EQUIPMENTS AND SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUFEMI
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:KILANKO
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:323-743-6026
Mailing Address - Street 1:1626 CENTINELA AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-1047
Mailing Address - Country:US
Mailing Address - Phone:323-743-6026
Mailing Address - Fax:
Practice Address - Street 1:1626 CENTINELA AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-1047
Practice Address - Country:US
Practice Address - Phone:323-747-5307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6456980001Medicare NSC