Provider Demographics
NPI:1841391646
Name:VITAL MEDICAL EQUIPMENT INC.
Entity Type:Organization
Organization Name:VITAL MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:IBECHEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-325-0091
Mailing Address - Street 1:910 LOMITA BLVD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2200
Mailing Address - Country:US
Mailing Address - Phone:310-325-0091
Mailing Address - Fax:310-325-7991
Practice Address - Street 1:910 LOMITA BLVD
Practice Address - Street 2:SUITE #2
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2200
Practice Address - Country:US
Practice Address - Phone:310-325-0091
Practice Address - Fax:310-325-7991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44631332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies