Provider Demographics
NPI:1356514699
Name:REHOBOT MEDICAL SUPPLIES & EQUIPMENTS, INC.
Entity type:Organization
Organization Name:REHOBOT MEDICAL SUPPLIES & EQUIPMENTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOBOLAJI
Authorized Official - Middle Name:
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-676-0406
Mailing Address - Street 1:3300 W ROSECRANS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8218
Mailing Address - Country:US
Mailing Address - Phone:310-676-0406
Mailing Address - Fax:310-676-0337
Practice Address - Street 1:3300 W ROSECRANS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-8218
Practice Address - Country:US
Practice Address - Phone:310-676-0406
Practice Address - Fax:310-676-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN