Provider Demographics
NPI:1669635660
Name:ARCADIA MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:ARCADIA MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEVAK
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAKOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-446-4046
Mailing Address - Street 1:616 E LIVE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5700
Mailing Address - Country:US
Mailing Address - Phone:626-446-4046
Mailing Address - Fax:626-446-4047
Practice Address - Street 1:616 E LIVE OAK AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5700
Practice Address - Country:US
Practice Address - Phone:626-446-4046
Practice Address - Fax:626-446-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49362332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6115870001Medicare NSC