Provider Demographics
NPI:1588639579
Name:FEWA MEDICAL SUPPLIES & EQUIPMENTS
Entity Type:Organization
Organization Name:FEWA MEDICAL SUPPLIES & EQUIPMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUFEMI
Authorized Official - Middle Name:T
Authorized Official - Last Name:OPANUBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-859-7733
Mailing Address - Street 1:20628 E ARROW HWY
Mailing Address - Street 2:#7
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1343
Mailing Address - Country:US
Mailing Address - Phone:626-859-7733
Mailing Address - Fax:626-859-7731
Practice Address - Street 1:20628 E ARROW HWY
Practice Address - Street 2:#7
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1343
Practice Address - Country:US
Practice Address - Phone:626-859-7733
Practice Address - Fax:626-859-7731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASR AP 100-367831332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03287FOtherMEDICAL- CROSSOVER
CADME03287FOtherMEDICAL- CROSSOVER