Provider Demographics
NPI:1306958681
Name:ND MEDICAL SUPPLIES
Entity type:Organization
Organization Name:ND MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:NNODU
Authorized Official - Middle Name:E
Authorized Official - Last Name:OJUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-329-4945
Mailing Address - Street 1:17725 CRENSHAW BLVD
Mailing Address - Street 2:STE 305
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-4138
Mailing Address - Country:US
Mailing Address - Phone:310-329-4945
Mailing Address - Fax:310-323-6349
Practice Address - Street 1:17725 CRENSHAW BLVD
Practice Address - Street 2:STE 305
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-4138
Practice Address - Country:US
Practice Address - Phone:310-329-4945
Practice Address - Fax:310-323-6349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101351332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4345380001Medicare ID - Type Unspecified