Provider Demographics
NPI:1629654652
Name:3 MED SUPPLY INC
Entity Type:Organization
Organization Name:3 MED SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALADEHEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-302-3633
Mailing Address - Street 1:21414 CHASE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-2658
Mailing Address - Country:US
Mailing Address - Phone:424-302-3633
Mailing Address - Fax:818-337-0384
Practice Address - Street 1:21414 CHASE ST STE 2
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-2658
Practice Address - Country:US
Practice Address - Phone:424-302-3633
Practice Address - Fax:818-337-0384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-21
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment