Lighthouse Medical Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LIGHTHOUSE MEDICAL SUPPLIES LLC

Practice address

9184 Wild Horse Ave
Hesperia, CA 92344-0047

Phone

(770) 891-1530

NPI assigned

Aug 8, 2019

Organization subpart

No

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

Authorized official

Name

Kristopher S Young

Title

Ceo

Phone

(770) 891-1530

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565222400000",
    "number": "1114572955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9184 WILD HORSE AVE",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923440047",
            "telephone_number": "770-891-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9184 WILD HORSE AVE",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923440047",
            "telephone_number": "770-891-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-891-1530"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Hesperia, CA
• Providers in Hesperia, 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 Aug 8, 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.