Modern Care Medical Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1216892 Issued in CT

Legal business name

MODERN CARE MEDICAL SUPPLIES LLC

Practice address

3780 Main St
Bridgeport, CT 06606-3610

Phone

(203) 870-8987

Fax

(203) 870-8988

NPI assigned

Apr 19, 2016

Organization subpart

No

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

Authorized official

Name

Olutayo Olumayowa OlukoyaNPI 1619321528

Title

Manager

Phone

(203) 243-8199

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olutayo Olukoya

  • Durable Medical Equipment & Medical Supplies
  • Bridgeport, CT
  • NPI 1619321528
  NPD (past) Authorized official

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461024000000",
    "number": "1033563770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063610",
            "telephone_number": "203-870-8987",
            "fax_number": "203-870-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063610",
            "telephone_number": "203-870-8987",
            "fax_number": "203-870-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN CARE MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A",
        "authorized_official_last_name": "OLUKOYA",
        "authorized_official_first_name": "OLUTAYO",
        "authorized_official_middle_name": "OLUMAYOWA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-243-8199"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "1216892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Lynn Mitchell
• Vanessa Mix
• Charles Haviland Mize, M.D.
• Mobile CV Imaging, LLC
• Mobile Orthotic & Prosthetic Services
• Modern Era Pediatric Practice
• Ingrid E Mody, PA-C
• Oak Gar Moe
• Andrea Teresa Moenkemoeller
• Balaphanidhar Mogga, MD

• Durable Medical Equipment & Medical Supplies in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.