Elite Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ELITE MEDICAL SUPPLY, INC.

Doing business as

Elite Medical Supply, Inc.

Practice address

7217 S Western Ave
Oklahoma City, OK 73139-2005

Phone

(405) 632-2755

Fax

(405) 632-5244

NPI assigned

Jun 24, 2005

Last updated

Sep 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shemin Aboo

Title

Ceo

Phone

(405) 632-2755

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elite Medical Supply, Inc. Doing business as

Locations

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1215933171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19635",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731440635",
            "telephone_number": "405-632-2755",
            "fax_number": "405-632-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7217 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392005",
            "telephone_number": "405-632-2755",
            "fax_number": "405-632-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "ABOO",
        "authorized_official_first_name": "SHEMIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-632-2755",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200048830A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Medical Supply, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Durable Medical Equipment & Medical Supplies in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.