Diversified Medical Distribution Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

MP00275 Issued in NV

Legal business name

DIVERSIFIED MEDICAL DISTRIBUTION INC.

Practice address

3035 E Patrick LN
Ste # 1
Las Vegas, NV 89120-4930

Phone

(866) 660-0567

Fax

(866) 425-6020

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Rameen Rastinehad, BSBA

Title

Manager

Phone

(800) 348-6337

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1013045806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 E PATRICK LN",
            "address_2": "STE # 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891204930",
            "telephone_number": "866-660-0567",
            "fax_number": "866-425-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 E PATRICK LN",
            "address_2": "STE # 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891204930",
            "telephone_number": "866-660-0567",
            "fax_number": "866-425-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED MEDICAL DISTRIBUTION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "RASTINEHAD",
        "authorized_official_first_name": "RAMEEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "800-348-6337",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSBA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NV",
            "license": "MP00275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NV BUSINESS LIC",
            "identifier": "192495",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCREDITATION COMMISSION FOR HEALTH CARE, INC.",
            "identifier": "37533",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Durable Medical Equipment & Medical Supplies in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.