Provider Demographics
NPI:1295992253
Name:WHITTIER MEDICAL HOMECARE SUPPLY INC
Entity type:Organization
Organization Name:WHITTIER MEDICAL HOMECARE SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / CFO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-630-1716
Mailing Address - Street 1:12633 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2927
Mailing Address - Country:US
Mailing Address - Phone:562-945-5556
Mailing Address - Fax:562-945-8577
Practice Address - Street 1:12633 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2927
Practice Address - Country:US
Practice Address - Phone:562-945-5556
Practice Address - Fax:562-945-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ82429ZMedicaid
CA0330330001Medicare NSC