1518478478 NPI number — GLOBAL MERCANTILE INC

Table of content: (NPI 1518478478)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518478478 NPI number — GLOBAL MERCANTILE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GLOBAL MERCANTILE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE MED SUPPLY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518478478
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13154 LEADWELL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH HOLLYWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91605-4117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-394-3917
Provider Business Mailing Address Fax Number:
800-912-9381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28863 INDUSTRY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALENCIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91355-5419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-394-3917
Provider Business Practice Location Address Fax Number:
800-912-9381
Provider Enumeration Date:
10/18/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOORANI
Authorized Official First Name:
ROOZBEH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
818-751-9543

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  96941 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)