Provider Demographics
NPI:1750471504
Name:CONTEMPO MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:CONTEMPO MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUMMAI
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-295-9009
Mailing Address - Street 1:8505 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-1915
Mailing Address - Country:US
Mailing Address - Phone:323-295-9009
Mailing Address - Fax:323-971-8294
Practice Address - Street 1:8505 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-1915
Practice Address - Country:US
Practice Address - Phone:323-295-9009
Practice Address - Fax:323-971-8294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45428332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5709210001Medicare NSC