Provider Demographics
NPI:1568789196
Name:MMK MEDICAL PRODUCTS INC.
Entity Type:Organization
Organization Name:MMK MEDICAL PRODUCTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FARKHOD
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKHAMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-506-4000
Mailing Address - Street 1:5430 CAHUENGA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-2917
Mailing Address - Country:US
Mailing Address - Phone:818-506-4000
Mailing Address - Fax:818-506-4040
Practice Address - Street 1:5430 CAHUENGA BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2917
Practice Address - Country:US
Practice Address - Phone:818-506-4000
Practice Address - Fax:818-506-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000246405400013332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6457010001Medicare NSC