Provider Demographics
NPI:1790891398
Name:FLOWER MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:FLOWER MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHANG
Authorized Official - Middle Name:HYANG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-233-7098
Mailing Address - Street 1:4004 S VERMONT AVE
Mailing Address - Street 2:#1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037
Mailing Address - Country:US
Mailing Address - Phone:323-233-7098
Mailing Address - Fax:323-233-1173
Practice Address - Street 1:4004 S VERMONT AVE
Practice Address - Street 2:#1
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037
Practice Address - Country:US
Practice Address - Phone:323-233-7098
Practice Address - Fax:323-233-1173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4590520001Medicare ID - Type Unspecified