Provider Demographics
NPI:1699792259
Name:VIEW PARK MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:VIEW PARK MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABIMBOLA
Authorized Official - Middle Name:BABATUNDE
Authorized Official - Last Name:OSIFESO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-644-1635
Mailing Address - Street 1:14115 CRENSHAW BLVD
Mailing Address - Street 2:STE # 8
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-7881
Mailing Address - Country:US
Mailing Address - Phone:310-644-1635
Mailing Address - Fax:310-644-2863
Practice Address - Street 1:14115 CRENSHAW BLVD
Practice Address - Street 2:STE # 8
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-7881
Practice Address - Country:US
Practice Address - Phone:310-644-1635
Practice Address - Fax:310-644-2863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
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
4219100001Medicare ID - Type Unspecified