Provider Demographics
NPI:1942800800
Name:ADE MEDICAL AND EQUIPMENTS SUPPLIERS, LLC
Entity Type:Organization
Organization Name:ADE MEDICAL AND EQUIPMENTS SUPPLIERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRINCE
Authorized Official - Middle Name:LUCKY
Authorized Official - Last Name:UMUKORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-374-8221
Mailing Address - Street 1:14205 INGLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-6729
Mailing Address - Country:US
Mailing Address - Phone:424-374-8221
Mailing Address - Fax:
Practice Address - Street 1:14205 INGLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-6729
Practice Address - Country:US
Practice Address - Phone:424-374-8221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies