Provider Demographics
NPI:1154387835
Name:ABILITY MEDICAL DISTRIBUTORS
Entity type:Organization
Organization Name:ABILITY MEDICAL DISTRIBUTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MFON
Authorized Official - Middle Name:ESSIEN
Authorized Official - Last Name:UMOREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-644-5466
Mailing Address - Street 1:13413 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-6335
Mailing Address - Country:US
Mailing Address - Phone:310-644-5466
Mailing Address - Fax:310-644-5655
Practice Address - Street 1:13413 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-6335
Practice Address - Country:US
Practice Address - Phone:310-644-5466
Practice Address - Fax:310-644-5655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-22
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4464060001Medicare NSC
CA4464060001Medicare NSC