Spectrum Medical and Equipment Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

103779 Issued in CA

Legal business name

SPECTRUM MEDICAL AND EQUIPMENT SUPPLY

Practice address

2601 Del Rosa Ave
B240-Suite 104
San Bernardino, CA 92404-4412

Phone

(909) 380-5025

Fax

(909) 886-2263

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Charles Okpala

Title

Ceo

Phone

(909) 886-2263

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262563200000",
    "number": "1144245069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 DEL ROSA AVE",
            "address_2": "B240-SUITE 104",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044412",
            "telephone_number": "909-380-5025",
            "fax_number": "909-886-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 DEL ROSA AVE",
            "address_2": "B240-SUITE 104",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044412",
            "telephone_number": "909-380-5025",
            "fax_number": "909-886-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM MEDICAL AND EQUIPMENT SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2010-01-04",
        "status": "A",
        "authorized_official_last_name": "OKPALA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-886-2263"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "103779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in San Bernardino, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.