Provider Demographics
NPI:1700940665
Name:AMERICAN MEDICAL SUPPLY
Entity Type:Organization
Organization Name:AMERICAN MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MASOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:BARUKZIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-656-9399
Mailing Address - Street 1:931 E MONTE VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-0403
Mailing Address - Country:US
Mailing Address - Phone:209-656-9399
Mailing Address - Fax:209-656-9499
Practice Address - Street 1:931 E MONTE VISTA AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-0403
Practice Address - Country:US
Practice Address - Phone:209-656-9399
Practice Address - Fax:209-656-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46261332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies