Agomo Home Medical Supplies, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

55075 Issued in CA

Legal business name

AGOMO HOME MEDICAL SUPPLIES, INC.

Doing business as

AGOMO HOME MEDICAL SUPPLIES

Practice address

10638 Burbank Blvd
North Hollywood, CA 91601-2511

Phone

(818) 985-1753

Fax

(818) 985-1593

NPI assigned

May 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dennis Ponce

Title

President

Phone

(562) 704-6190

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AGOMO HOME MEDICAL SUPPLIES Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1376597781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10638 BURBANK BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "91601",
            "telephone_number": "818-985-1753",
            "fax_number": "818-985-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10638 BURBANK BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012511",
            "telephone_number": "818-985-1753",
            "fax_number": "818-985-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGOMO HOME MEDICAL SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "PONCE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-704-6190"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "55075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME03157F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AGOMO HOME MEDICAL SUPPLIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dino Aghaians, PHARM D
• Kiavash Aghajani
• Annie Aghajanian-Aboulian, DMD
• Natasha Agharabi
• Hasmik Aghazaryan
• Agra Medical Group Apc
• Angelica Maria Aguilar
• Martha Aguilar
• Aida Sahakian DDS Inc
• AIDS Healthcare Foundation

• Durable Medical Equipment & Medical Supplies in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.