| Organization Name: | GERTRUDE IHENACHOR |
| NPI Number: | 1407945504 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GERTRUDE ULOMA IHENACHOR (OWNER) |
| Mailing Address: | 825 W Gardena Blvd Gardena |
| State: | CA US |
| Postal Code: | 902473030 |
| Phone Number: | 3103276977 |
| Fax Number: | 3103276980 |
| NPI Enumeration Date: | 10/12/2006 |
| NPI Last Update Date: | 09/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 51946 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |