Provider Demographics
NPI:1629256821
Name:ENA MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:ENA MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PKHRIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-535-3190
Mailing Address - Street 1:13422 N CAVE CREEK RD
Mailing Address - Street 2:STE# 2
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-5165
Mailing Address - Country:US
Mailing Address - Phone:602-535-3190
Mailing Address - Fax:602-535-3190
Practice Address - Street 1:13422 N CAVE CREEK RD
Practice Address - Street 2:STE# 2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5165
Practice Address - Country:US
Practice Address - Phone:602-535-3190
Practice Address - Fax:602-535-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies