Kimbo Medical Distributor

LBN: Kimbo Medical Distributor
Kimbo Medical Distributor is an health care organization with primary practice located at 407 N Avalon Blvd , Wilmington CA 90744-5803. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Oxygen Equipment & Supplies, Suppliers / Prosthetic/Orthotic Supplier. Suppliers / Parenteral & Enteral Nutrition is the primary health care specialty. Kimbo Medical Distributor can be contacted via phone (310) 834-9574, or through Tamunang, Godwill Tabe via phone (310) 834-9574.

Contact Information

Primary practice address
407 N Avalon Blvd Wilmington CA 90744-5803
Phone: (310) 834-9574
Fax: (866) 398-5898
Website:
Map and Directions
Authorized official contact:
Name: Tamunang, Godwill Tabe Physical Therapist (PT)
Phone: (310) 834-9574

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 44548 California
Suppliers / Parenteral & Enteral Nutrition 332BP3500X 44548 California
Suppliers / Oxygen Equipment & Supplies 332BX2000X 44548 California
Suppliers / Prosthetic/Orthotic Supplier 335E00000X 44548 California

Profile Details

NPI number 1891916367
LBN Legal business name Kimbo Medical Distributor
DBA Doing business as Kimbo Medical Distributor
Authorized official Tamunang, Godwill Tabe Physical Therapist (PT)
Entity Organization
Organization subpart 1 No
Enumeration date May 1st, 2007
Last updated Nov 9th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891916367 NPPES
California MEDICAID CMCSUBT9E

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