NPIMap

Organization Active NPI

Peterson Medical Supply Company

  • Durable Medical Equipment & Medical Supplies
  • East Hampton, NY
National Provider Identifier
1003183658
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PETERSON MEDICAL SUPPLY COMPANY
Practice address
400 Pantigo Rd
East Hampton, NY 11937-2699
Phone
(631) 324-3200
Fax
(631) 324-3676
NPI assigned
Nov 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Erik Baekeland Peterson, PTNPI 1558525311
Title
President
Phone
(631) 324-3200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

400 Pantigo Rd
East Hampton, NY 11937-2699

Mailing address

PO Box 2835
Amagansett, NY 11930-2835
Phone (631) 324-3200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1003183658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2835",
            "city": "AMAGANSETT",
            "state": "NY",
            "postal_code": "119302835",
            "telephone_number": "631-324-3200",
            "fax_number": "631-324-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PANTIGO RD",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119372699",
            "telephone_number": "631-324-3200",
            "fax_number": "631-324-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON MEDICAL SUPPLY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "BAEKELAND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-324-3200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hampton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.