Avid Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

AVID MEDICAL SUPPLY INC

Practice address

64 N Pecos Rd Ste 600
Henderson, NV 89074-7354

Phone

(800) 282-3166

Fax

(725) 218-3446

NPI assigned

Mar 17, 2022

Last updated

Mar 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angel Vasquez

Title

Secretary

Phone

(800) 282-3166

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1144978156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 N PECOS RD STE 600",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747354",
            "telephone_number": "800-282-3166",
            "fax_number": "725-218-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 N PECOS RD STE 600",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747354",
            "telephone_number": "800-282-3166",
            "fax_number": "725-218-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVID MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "800-282-3166"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Mar 18, 2022; 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.