Provider Demographics
NPI:1922197466
Name:ACHIEVE COMFORT MEDICAL EQUIPMENT & SUPPLY, INC.
Entity Type:Organization
Organization Name:ACHIEVE COMFORT MEDICAL EQUIPMENT & SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAROUKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-852-6900
Mailing Address - Street 1:PO BOX 49780
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-0780
Mailing Address - Country:US
Mailing Address - Phone:323-852-6900
Mailing Address - Fax:
Practice Address - Street 1:370 S FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3138
Practice Address - Country:US
Practice Address - Phone:323-852-6900
Practice Address - Fax:323-852-6904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44784332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03103FMedicaid
CA4198330001Medicare ID - Type UnspecifiedPROVIDER#