Elk Grove Medical & Dental Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

5395690001 Issued in CA

Legal business name

ELK GROVE MEDICAL & DENTAL SUPPLY

Practice address

8139 Elk Grove Blvd
Suite 155
Elk Grove, CA 95758-5519

Phone

(916) 691-4200

Fax

(916) 691-4245

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Miss Davies Ononiwu

Title

Owner

Phone

(916) 691-4200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235165804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8139 ELK GROVE BLVD",
            "address_2": "SUITE 155",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585519",
            "telephone_number": "916-691-4200",
            "fax_number": "916-691-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8139 ELK GROVE BLVD",
            "address_2": "SUITE 155",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585519",
            "telephone_number": "916-691-4200",
            "fax_number": "916-691-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE MEDICAL & DENTAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ONONIWU",
        "authorized_official_first_name": "DAVIES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-691-4200",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "5395690001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elk Grove Family Physicians Medical Group Inc
• Elk Grove Foot and Ankle PC
• Elk Grove Hearing Care
• Elk Grove Hearing Clinic, Inc.
• Elk Grove Home Health Inc
• Elk Grove Medical Supplies, Inc
• Elk Grove Natural Health
• Elk Grove Optometry a Professional Corporation
• Elk Grove Pediatrics, Inc
• Elk Grove Pharmacy Inc

• Durable Medical Equipment & Medical Supplies in Elk Grove, CA
• Providers in Elk Grove, 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 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.