Provider Demographics
NPI:1639374929
Name:CORE MEDICAL
Entity Type:Organization
Organization Name:CORE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEFKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-991-7676
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:AGOURA
Mailing Address - State:CA
Mailing Address - Zip Code:91376-0391
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5421 JON DODSON DR
Practice Address - Street 2:AGOURA HILLS
Practice Address - City:AGOURA
Practice Address - State:CA
Practice Address - Zip Code:91301-2050
Practice Address - Country:US
Practice Address - Phone:818-991-7676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies