Provider Demographics
NPI:1861673857
Name:RUZER MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:RUZER MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EBENEZER
Authorized Official - Middle Name:O
Authorized Official - Last Name:BANKOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-354-0018
Mailing Address - Street 1:16300 CRENSHAW BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-1439
Mailing Address - Country:US
Mailing Address - Phone:310-354-0018
Mailing Address - Fax:310-354-0019
Practice Address - Street 1:16300 CRENSHAW BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-1439
Practice Address - Country:US
Practice Address - Phone:310-354-0018
Practice Address - Fax:310-354-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-18
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48139332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6029630001Medicare NSC