Supreme Medical &Surgical Equipment Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SUPREME MEDICAL &SURGICAL EQUIPMENT SUPPLY LLC

Practice address

1230 Springfield Ave
Irvington, NJ 07111-1982

Phone

(973) 399-4009

Fax

(973) 399-4033

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Charles Idemudia Igiehon

Title

Ceo

Phone

(973) 399-4009

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215019757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6355",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071060355",
            "telephone_number": "973-399-4009",
            "fax_number": "973-399-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 SPRINGFIELD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111982",
            "telephone_number": "973-399-4009",
            "fax_number": "973-399-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME MEDICAL &SURGICAL EQUIPMENT SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IGIEHON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "IDEMUDIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-399-4009",
        "authorized_official_name_prefix": "Mr."
    },
    "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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• Durable Medical Equipment & Medical Supplies in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.