Provider Demographics
NPI:1508914821
Name:RL MEDICAL SUPPLY
Entity Type:Organization
Organization Name:RL MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:USIK
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRAKOSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-352-4599
Mailing Address - Street 1:7301 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2720
Mailing Address - Country:US
Mailing Address - Phone:818-352-4599
Mailing Address - Fax:818-352-4177
Practice Address - Street 1:7301 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2720
Practice Address - Country:US
Practice Address - Phone:818-352-4599
Practice Address - Fax:818-352-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies