Provider Demographics
NPI:1730105131
Name:A-1 MEDICAL SUPPLIES CORPORATION
Entity Type:Organization
Organization Name:A-1 MEDICAL SUPPLIES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KADANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-324-6274
Mailing Address - Street 1:14512 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-3145
Mailing Address - Country:US
Mailing Address - Phone:310-324-6274
Mailing Address - Fax:
Practice Address - Street 1:14512 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-3145
Practice Address - Country:US
Practice Address - Phone:310-324-6274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45659OtherHMDR LICENCE NUMBER