Provider Demographics
NPI:1740318260
Name:E.N.A. MEDICAL SUPPLY, INC.
Entity type:Organization
Organization Name:E.N.A. MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIKAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVASARDYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-273-7878
Mailing Address - Street 1:38345 30TH STREET E
Mailing Address - Street 2:SUITE E6
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4984
Mailing Address - Country:US
Mailing Address - Phone:661-273-7878
Mailing Address - Fax:661-273-7877
Practice Address - Street 1:38345 30TH STREET E
Practice Address - Street 2:SUITE E6
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4984
Practice Address - Country:US
Practice Address - Phone:661-273-7878
Practice Address - Fax:661-273-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5956660001Medicare NSC