Provider Demographics
NPI:1336273770
Name:NORTHRIDGE HAVEN INC
Entity Type:Organization
Organization Name:NORTHRIDGE HAVEN INC
Other - Org Name:E AND C AQUINTEY MEDICAL SUPPLY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:LOYOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-648-5402
Mailing Address - Street 1:10753 LURLINE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1634
Mailing Address - Country:US
Mailing Address - Phone:818-648-5402
Mailing Address - Fax:
Practice Address - Street 1:10753 LURLINE AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-1634
Practice Address - Country:US
Practice Address - Phone:818-648-5402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies