Provider Demographics
NPI:1609045632
Name:FLEX MEDICAL EQUIPMENT DISTRIBUTORS INC
Entity Type:Organization
Organization Name:FLEX MEDICAL EQUIPMENT DISTRIBUTORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:OKORAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-815-1129
Mailing Address - Street 1:PO BOX 2220
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91769-2220
Mailing Address - Country:US
Mailing Address - Phone:909-622-1143
Mailing Address - Fax:909-622-4600
Practice Address - Street 1:1180 E HOLT AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-5859
Practice Address - Country:US
Practice Address - Phone:909-622-1143
Practice Address - Fax:909-622-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48840332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6154850001Medicare NSC