Provider Demographics
NPI:1679009039
Name:DX MEDICAL INDUSTRIES, LLC
Entity Type:Organization
Organization Name:DX MEDICAL INDUSTRIES, LLC
Other - Org Name:DYNAMIC ORTHO SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOSI
Authorized Official - Middle Name:HAIDOSTIAN
Authorized Official - Last Name:AVAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-819-2773
Mailing Address - Street 1:5656 SANTA MONICA BLVD
Mailing Address - Street 2:UNIT G
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90038-2992
Mailing Address - Country:US
Mailing Address - Phone:323-819-2773
Mailing Address - Fax:888-977-3393
Practice Address - Street 1:5656 SANTA MONICA BLVD
Practice Address - Street 2:UNIT G
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-2992
Practice Address - Country:US
Practice Address - Phone:323-819-2773
Practice Address - Fax:888-977-3393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies