Broadway Medical Supply

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

Legal business name

BROADWAY MEDICAL SUPPLY

Practice address

8512 S Broadway
Los Angeles, CA 90003-3335

Phone

(323) 752-7831

NPI assigned

Mar 24, 2008

Last updated

Dec 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan O Osioh

Title

Owner

Phone

(323) 752-7831

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1033381637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73571",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900030571",
            "telephone_number": "323-752-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8512 S BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900033335",
            "telephone_number": "323-752-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "OSIOH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-752-7831"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doreatha Broadnax
• Tiler Broadnax
• Broadview, Inc.
• Broadwater Sunray Care Center, LLC (Sunray Healthcare Center)
• Broadway Mammography, LLC
• Broadway Radiology, Inc.
• Rosita Louise Broaster-Lotiff, MA
• Adela Brock
• Amina Brock
• Melissa Marie Brock

• Parenteral & Enteral Nutrition Supplies (DME) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.