Provider Demographics
NPI:1336350727
Name:NEW HOPE MEDICAL SUPPLY
Entity Type:Organization
Organization Name:NEW HOPE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EJIKE
Authorized Official - Last Name:EJIMEOGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-263-7047
Mailing Address - Street 1:13663 PRAIRIE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-7372
Mailing Address - Country:US
Mailing Address - Phone:310-263-7047
Mailing Address - Fax:310-263-1859
Practice Address - Street 1:13663 PRAIRIE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-7372
Practice Address - Country:US
Practice Address - Phone:310-263-7047
Practice Address - Fax:310-263-1859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102952332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA17632OtherEXEMPTEE
CA17632OtherEXEMPTEE
CA4876880001Medicare ID - Type UnspecifiedHOME MEDICAL EQUIPMENT