On the Go Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

98950 Issued in CA

Legal business name

ON THE GO MEDICAL SUPPLY, LLC

Practice address

12421 Hesperia Rd Ste 1
Victorville, CA 92395-7704

Phone

(760) 552-4075

Fax

(760) 552-4023

NPI assigned

Jun 29, 2018

Organization subpart

No

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

Authorized official

Name

Adriana Nawaz

Title

Owner

Phone

(760) 552-4075

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530230400000",
    "number": "1134614274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12421 HESPERIA RD STE 1",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957704",
            "telephone_number": "760-552-4075",
            "fax_number": "760-552-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12421 HESPERIA RD STE 1",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957704",
            "telephone_number": "760-552-4075",
            "fax_number": "760-552-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON THE GO MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A",
        "authorized_official_last_name": "NAWAZ",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-552-4075"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "98950",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.