Provider Demographics
NPI:1841424363
Name:KING HILL MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:KING HILL MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:UGWUEZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-242-9700
Mailing Address - Street 1:2930 W IMPERIAL HWY
Mailing Address - Street 2:UNIT 200 D
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90303-3143
Mailing Address - Country:US
Mailing Address - Phone:323-242-9700
Mailing Address - Fax:323-242-9800
Practice Address - Street 1:2930 W IMPERIAL HWY
Practice Address - Street 2:UNIT 200 D
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-3143
Practice Address - Country:US
Practice Address - Phone:323-242-9700
Practice Address - Fax:323-242-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51778332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6343940001Medicare NSC