Provider Demographics
NPI:1487975298
Name:ON TIME MEDICAL EQUIPMENT & SUPPLY
Entity type:Organization
Organization Name:ON TIME MEDICAL EQUIPMENT & SUPPLY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAPETYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-550-8899
Mailing Address - Street 1:113 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2174
Mailing Address - Country:US
Mailing Address - Phone:818-550-9988
Mailing Address - Fax:866-840-5513
Practice Address - Street 1:113 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2174
Practice Address - Country:US
Practice Address - Phone:818-550-9988
Practice Address - Fax:866-840-5513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127629833935331L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes331L00000XSuppliersBlood Bank