Provider Demographics
NPI:1497793871
Name:SARAH MEDICAL EQUIPMENT INC.
Entity type:Organization
Organization Name:SARAH MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:SALARKIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-396-5258
Mailing Address - Street 1:2632 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4620
Mailing Address - Country:US
Mailing Address - Phone:310-396-5258
Mailing Address - Fax:
Practice Address - Street 1:14412 HAMLIN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1409
Practice Address - Country:US
Practice Address - Phone:310-396-5258
Practice Address - Fax:310-496-2765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASR AS 99883063332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME01555GMedicaid
CA0492470001Medicare NSC
CA0492470001Medicare PIN