| Organization Name: | IMPERIAL MEDICAL SUPPLY, INC. |
| NPI Number: | 1417972381 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HOWARD M WEISS (CEO) |
| Mailing Address: | 16666 E Johnson Dr Suite # C City Of Industry |
| State: | CA US |
| Postal Code: | 917452412 |
| Phone Number: | 8007009565 |
| Fax Number: | 8004503718 |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 09/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 101028 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |