1033277520 NPI number — SAMSUNG MEDICAL SUPPLIES USA CORP.

Table of content: LAUREN BRITTNEY MITSUKO PALMER (NPI 1922610062)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033277520 NPI number — SAMSUNG MEDICAL SUPPLIES USA CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAMSUNG MEDICAL SUPPLIES USA CORP.
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:
Provider Other Organization Name Type Code:
6
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:
1033277520
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2727 W OLYMPIC BLVD
Provider Second Line Business Mailing Address:
112
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90006-2637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-388-8230
Provider Business Mailing Address Fax Number:
213-388-8678

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2727 W OLYMPIC BLVD
Provider Second Line Business Practice Location Address:
112
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90006-2637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-388-8230
Provider Business Practice Location Address Fax Number:
213-388-8678
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RYU
Authorized Official First Name:
BUMI
Authorized Official Middle Name:
T
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
213-388-8230

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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