Provider Demographics
NPI:1649417700
Name:LINAS MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:LINAS MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZAROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-550-9191
Mailing Address - Street 1:1754 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-2865
Mailing Address - Country:US
Mailing Address - Phone:818-550-9191
Mailing Address - Fax:818-550-9194
Practice Address - Street 1:1754 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-2865
Practice Address - Country:US
Practice Address - Phone:818-550-9191
Practice Address - Fax:818-550-9194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0002397564-0001-3332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6326780001Medicare NSC