Promed Supply LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

PROMED SUPPLY LLC

Practice address

16045 Sherman Way Ste C
Van Nuys, CA 91406-4085

Phone

(818) 616-4348

Fax

(818) 616-4134

NPI assigned

Jun 26, 2019

Organization subpart

No

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

Authorized official

Name

Petros Patatanian

Title

President

Phone

(818) 616-4348

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1043871403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16045 SHERMAN WAY STE C",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914064085",
            "telephone_number": "818-616-4348",
            "fax_number": "818-616-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16045 SHERMAN WAY STE C",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914064085",
            "telephone_number": "818-616-4348",
            "fax_number": "818-616-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "PATATANIAN",
        "authorized_official_first_name": "PETROS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-616-4348"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.