Entech Medical Corporation

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

Legal business name

ENTECH MEDICAL CORPORATION

Practice address

1910 D St
La Verne, CA 91750-5410

Phone

(909) 596-6785

Fax

(909) 596-0052

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

Mrs. Debra Hoffstetter

Title

Ceo

Phone

(909) 596-6785

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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": "1255367819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 D ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917505410",
            "telephone_number": "909-596-6785",
            "fax_number": "909-596-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 D ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917505410",
            "telephone_number": "909-596-6785",
            "fax_number": "909-596-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENTECH MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOFFSTETTER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-596-6785",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME00666G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808842",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Econo Drugs Inc
• Sheena Edmonds, MS, LMFT
• Craig Yoshio Endo, M.D.
• Tiffany P. Le Endo, D.O.
• Joanna Rachel Engel, ATC
• Eon Resources Corp
• Manuel Antonio Escalante Jr., ATC
• Marissa Selina Esquibel
• Melanie Estrada
• Andrew Eusebio Jr.

• Parenteral & Enteral Nutrition Supplies (DME) in La Verne, CA
• Providers in La Verne, CA by specialty
• Parenteral & Enteral Nutrition Supplies (DME) 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.