Provider Demographics
NPI:1972709467
Name:A.Y. MEDICAL SUPLLIES INC.
Entity Type:Organization
Organization Name:A.Y. MEDICAL SUPLLIES INC.
Other - Org Name:A.Y. MEDICAL SUPPLIES INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EKUNDAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:AYO ERHABOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-773-9777
Mailing Address - Street 1:2500 W ORANGETHORPE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-4237
Mailing Address - Country:US
Mailing Address - Phone:714-773-9777
Mailing Address - Fax:714-773-9393
Practice Address - Street 1:2500 W ORANGETHORPE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-4237
Practice Address - Country:US
Practice Address - Phone:714-773-9777
Practice Address - Fax:714-773-9393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47369332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6013400001Medicare NSC