Promed Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROMED INC

Practice address

1401 S Beretania St
Suite 620
Honolulu, HI 96814-1870

Phone

(808) 396-1316

Fax

(808) 356-0391

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Thibodeaux, DME SUPPLIER

Title

Vice President

Phone

(844) 633-6287

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CADE Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Promed, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Temecula, CA
  • NPI 1609233543

  5991826299

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Promed Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Promed, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Temecula, CA
  • NPI 1609233543
  NPD tax ID

Locations

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1164464707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27383 VIA INDUSTRIA",
            "address_2": "SUITE 200",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925903699",
            "telephone_number": "808-396-1316",
            "fax_number": "808-356-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST",
            "address_2": "SUITE 620",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141870",
            "telephone_number": "808-396-1316",
            "fax_number": "808-356-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "THIBODEAUX",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "844-633-6287",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DME SUPPLIER"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52514901",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CADE Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Durable Medical Equipment & Medical Supplies in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.