Provider Demographics
NPI:1518195288
Name:NNE MEDICAL SUPPLY AND EQUIPMENT INC
Entity Type:Organization
Organization Name:NNE MEDICAL SUPPLY AND EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERROYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-337-2000
Mailing Address - Street 1:13105 RAMONA BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:IRWINDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91706-3858
Mailing Address - Country:US
Mailing Address - Phone:626-337-2000
Mailing Address - Fax:626-337-2006
Practice Address - Street 1:13105 RAMONA BLVD STE B
Practice Address - Street 2:
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91706-3858
Practice Address - Country:US
Practice Address - Phone:626-337-2000
Practice Address - Fax:626-337-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51412332B00000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5692480001Medicare NSC