Provider Demographics
NPI:1780731927
Name:L AND P MEDICAL SUPPLY, INC.
Entity type:Organization
Organization Name:L AND P MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LANGRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-766-2955
Mailing Address - Street 1:335 E ALBERTONI ST
Mailing Address - Street 2:200-105
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1425
Mailing Address - Country:US
Mailing Address - Phone:323-766-2955
Mailing Address - Fax:323-766-2951
Practice Address - Street 1:1828 S WESTERN AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5808
Practice Address - Country:US
Practice Address - Phone:323-766-2955
Practice Address - Fax:323-766-2951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45845332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5900320001Medicare NSC