Provider Demographics
NPI:1588836902
Name:MORE THAN LIFE MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:MORE THAN LIFE MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-665-9446
Mailing Address - Street 1:1620 CENTINELA AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-1045
Mailing Address - Country:US
Mailing Address - Phone:310-665-9446
Mailing Address - Fax:310-665-9449
Practice Address - Street 1:1620 CENTINELA AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-1045
Practice Address - Country:US
Practice Address - Phone:310-665-9446
Practice Address - Fax:310-665-9449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49138332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA49138OtherHMDR
CA6150870001Medicare NSC