Provider Demographics
NPI:1972345742
Name:WHABA MEDICAL INC
Entity type:Organization
Organization Name:WHABA MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHILOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-935-4599
Mailing Address - Street 1:1243 S OLIVE ST APT 634
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3799
Mailing Address - Country:US
Mailing Address - Phone:619-935-4599
Mailing Address - Fax:619-935-4771
Practice Address - Street 1:1243 S OLIVE ST APT 634
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3799
Practice Address - Country:US
Practice Address - Phone:619-935-4599
Practice Address - Fax:619-935-4771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies