Provider Demographics
NPI:1255121125
Name:MSB TECH LLC
Entity type:Organization
Organization Name:MSB TECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELITA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGANESYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-307-6212
Mailing Address - Street 1:12107 GERALD AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-2604
Mailing Address - Country:US
Mailing Address - Phone:818-307-6212
Mailing Address - Fax:
Practice Address - Street 1:721 E GARFIELD AVE APT 2
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2920
Practice Address - Country:US
Practice Address - Phone:818-307-6212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies