Provider Demographics
NPI:1497997308
Name:NOKO MEDICAL SUPPLY COMPANY
Entity Type:Organization
Organization Name:NOKO MEDICAL SUPPLY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLUMBUS
Authorized Official - Middle Name:E
Authorized Official - Last Name:OKON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:623-847-7979
Mailing Address - Street 1:5060 W BETHANY HOME RD STE 4
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-5269
Mailing Address - Country:US
Mailing Address - Phone:623-847-7979
Mailing Address - Fax:623-847-7987
Practice Address - Street 1:5060 W BETHANY HOME RD STE 4
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-5269
Practice Address - Country:US
Practice Address - Phone:623-847-7979
Practice Address - Fax:623-847-7987
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOKO MEDICAL COMPANY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies