Provider Demographics
NPI:1194997353
Name:LABOD MEDICAL SUPPLIES INC.
Entity type:Organization
Organization Name:LABOD MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUSOLA
Authorized Official - Middle Name:ADIO
Authorized Official - Last Name:OLABODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-256-9677
Mailing Address - Street 1:17050 CHATSWORTH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5847
Mailing Address - Country:US
Mailing Address - Phone:818-832-5100
Mailing Address - Fax:818-832-5101
Practice Address - Street 1:17050 CHATSWORTH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5847
Practice Address - Country:US
Practice Address - Phone:818-832-5100
Practice Address - Fax:818-832-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6159430001Medicare NSC