Provider Demographics
NPI:1205593415
Name:FISCHER MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:FISCHER MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LUCA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-573-1399
Mailing Address - Street 1:5400 ATLANTIS CT
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-7101
Mailing Address - Country:US
Mailing Address - Phone:818-668-3259
Mailing Address - Fax:
Practice Address - Street 1:5400 ATLANTIS CT
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-7101
Practice Address - Country:US
Practice Address - Phone:818-668-3259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies