Revolution Medical Supply

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

13417795909700 Issued in NY

Legal business name

REVOLUTION MEDICAL SUPPLY

Practice address

994 E 180TH St
Suite #4F
Bronx, NY 10460-2248

Phone

(469) 348-6910

NPI assigned

Jun 19, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Nduka Nduka

Title

Owner

Phone

(469) 348-6910

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1276905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1033430418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 494333",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750494333",
            "telephone_number": "469-348-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 E 180TH ST",
            "address_2": "SUITE #4F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104602248",
            "telephone_number": "469-348-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-19",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "NDUKA",
        "authorized_official_first_name": "NDUKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-348-6910",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NY",
            "license": "13417795909700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josef Reutershan, BSW
• Sofia Marie Reverendo, LMSW
• Revival Physical Therapy & Rehabilitation Services, PC
• Revive Pharmacy Inc
• Revive Psycho Therapy LLC
• Stephanie Lynn Revoredo
• Rex Medical P.C.
• Taina Belen Rexach
• Morayma Reyes Gil, M.D. PHD
• Sebastian Reyes Lizaola, MD

• Oxygen Equipment & Supplies (DME) in Bronx, NY
• Providers in Bronx, NY by specialty
• Oxygen Equipment & Supplies (DME) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.