Idamed Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

IDAMED INC

Practice address

17660 Newhope St
Suite F
Fountain Valley, CA 92708-4296

Phone

(714) 556-4663

Fax

(714) 556-4664

NPI assigned

Nov 4, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Gary Krantz

Title

President

Phone

(714) 556-4663

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AT HOME MEDICAL EQUIPMENT & SUPPLIES Doing business as

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": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1255668786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17660 NEWHOPE ST",
            "address_2": "SUITE F",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084296",
            "telephone_number": "714-556-4663",
            "fax_number": "714-556-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17660 NEWHOPE ST",
            "address_2": "SUITE F",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084296",
            "telephone_number": "714-556-4663",
            "fax_number": "714-556-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAMED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "KRANTZ",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-556-4663",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "1255668786",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AT HOME MEDICAL EQUIPMENT & SUPPLIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Fountain Valley, CA
• Providers in Fountain Valley, 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 Jun 9, 2014; 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.