Active Living Ostomy, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

009039 Issued in CA

Legal business name

ACTIVE LIVING OSTOMY, INC

Practice address

994 Thoroughbred LN
Norco, CA 92860-3861

Phone

(951) 808-9734

Fax

(951) 808-8603

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Girma Leggesse, NONE

Title

Owner/President

Phone

(951) 808-9734

Specialties & licenses 1

Addresses

Other names 1

• none Other name

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1184736209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 THOROUGHBRED LN",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603861",
            "telephone_number": "951-808-9734",
            "fax_number": "951-808-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 THOROUGHBRED LN",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603861",
            "telephone_number": "951-808-9734",
            "fax_number": "951-808-8603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIVING OSTOMY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "LEGGESSE",
        "authorized_official_first_name": "GIRMA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "951-808-9734",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NONE"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "009039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "none",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Norco, CA
• Providers in Norco, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.