Premier Medical Supply Services, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

46433 Issued in CA

Legal business name

PREMIER MEDICAL SUPPLY SERVICES, LLC

Practice address

2630 W. Manchester Blvd
Suite C
Inglewood, CA 90305-2434

Phone

(323) 750-7885

Fax

(323) 750-7890

NPI assigned

Mar 12, 2007

Last updated

Nov 4, 2007By 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. Mary K Fadipe

Title

Director of Operations

Phone

(323) 750-7885

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194134400000",
    "number": "1235261553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 W. MANCHESTER BLVD",
            "address_2": "SUITE C",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903052434",
            "telephone_number": "323-750-7885",
            "fax_number": "323-750-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 W. MANCHESTER BLVD",
            "address_2": "SUITE C",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903052434",
            "telephone_number": "323-750-7885",
            "fax_number": "323-750-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL SUPPLY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-11-04",
        "status": "A",
        "authorized_official_last_name": "FADIPE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "323-750-7885",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "46433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Inglewood, CA
• Providers in Inglewood, 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 Nov 4, 2007; 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.