Premier Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PREMIER MEDICAL SUPPLY

Practice address

122 Boden Ave
Valley Stream, NY 11580-5145

Phone

(917) 312-4500

Fax

(516) 740-2863

NPI assigned

Feb 1, 2013

Organization subpart

No

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

Authorized official

Name

Liela Amissah

Title

Owner

Phone

(917) 312-4500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1174862700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 BODEN AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805145",
            "telephone_number": "917-312-4500",
            "fax_number": "516-740-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 BODEN AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805145",
            "telephone_number": "917-312-4500",
            "fax_number": "516-740-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "AMISSAH",
        "authorized_official_first_name": "LIELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-312-4500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzette Powell, M.D.
• Edwin Pratt
• Mandell Pratt
• Precious Duhaney NP in Family Health PLLC
• Lunie Predestin, LPN
• Premier Physical Medicine & Rehabilitation, PC
• Gigi Pressley
• Aaron Jed Barlis Presto, PT, DPT
• Jean-Paul Pretat
• Joshua Priesman

• Durable Medical Equipment & Medical Supplies in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.