Provider Demographics
NPI:1992996854
Name:CASA GRANDE MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:CASA GRANDE MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARNIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-876-0787
Mailing Address - Street 1:241 W COTTONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-2403
Mailing Address - Country:US
Mailing Address - Phone:520-876-0787
Mailing Address - Fax:520-876-0798
Practice Address - Street 1:241 W COTTONWOOD LN
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-2403
Practice Address - Country:US
Practice Address - Phone:520-876-0787
Practice Address - Fax:520-876-0798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies