Prestige Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRESTIGE MEDICAL SUPPLY

Practice address

1320 West Gardena Blvd
#107
Gardena, CA 90247

Phone

(310) 324-0786

Fax

(310) 324-0211

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Joseph A Kermah

Title

Owner

Phone

(310) 324-0786

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1194892992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WEST GARDENA BLVD",
            "address_2": "#107",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "310-324-0786",
            "fax_number": "310-324-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WEST GARDENA BLVD",
            "address_2": "#107",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "310-324-0786",
            "fax_number": "310-324-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "KERMAH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-324-0786"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jada Lynette Price

• Durable Medical Equipment & Medical Supplies in Gardena, CA
• Providers in Gardena, 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 Jun 23, 2008; 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.