Main Street Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MAIN STREET MEDICAL SUPPLY LLC

Practice address

834 E Avenue K Ste B
Lancaster, CA 93535-4766

Phone

(661) 754-0439

NPI assigned

May 30, 2024

Organization subpart

No

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

Authorized official

Name

Margarita Tejeda

Title

Owner

Phone

(661) 754-0439

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1013757509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3654 TOSCANY CT",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935507919",
            "telephone_number": "661-754-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 E AVENUE K STE B",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354766",
            "telephone_number": "661-754-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-07-09",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "TEJEDA",
        "authorized_official_first_name": "MARGARITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-754-0439"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tom Mahendra, MD
• Mary Mahon
• Susan Lai Mahoney, PHARMD
• Stefanie Nicole Mahotz
• Lanh Mai, DDS
• Main Street Medical Supply LLC,
• Miranda Maisler, NP-C
• Jeorge T Makinose
• Luz Clarita Malagon Cisneros
• Ana E. Maldonado

• Durable Medical Equipment & Medical Supplies in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.