Indy Medical Supply Services

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

69000203A Issued in IN

Legal business name

INDY MEDICAL SUPPLY SERVICES

Doing business as

SAME AS ABOVE

Practice address

3737 North Meridian Street
Suite 503
Indianapolis, IN 46208-4308

Phone

(317) 280-8315

Fax

(317) 280-8355

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Camillus Richard Inyang, BS COMPUTER TECH

Title

President

Phone

(317) 280-8315

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SAME AS ABOVE Doing business as

Locations

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1265571939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 N MERIDIAN ST",
            "address_2": "SUITE 503",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084348",
            "telephone_number": "317-280-8315",
            "fax_number": "317-280-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 NORTH MERIDIAN STREET",
            "address_2": "SUITE 503",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084308",
            "telephone_number": "317-280-8315",
            "fax_number": "317-280-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDY MEDICAL SUPPLY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "INYANG",
        "authorized_official_first_name": "CAMILLUS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-280-8315",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS COMPUTER TECH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "69000203A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200444810A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAME AS ABOVE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.