Active Medical Supplies, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ACTIVE MEDICAL SUPPLIES, LLC

Practice address

855 Valley Rd
Clifton, NJ 07013-2441

Phone

(973) 506-4055

Fax

(973) 506-6728

NPI assigned

Oct 12, 2022

Last updated

Oct 12, 2022By 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

Kiley Escamilla

Title

Owner

Phone

(973) 506-4055

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1275259137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "074800820",
            "telephone_number": "973-506-4055",
            "fax_number": "973-506-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 VALLEY RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132441",
            "telephone_number": "973-506-4055",
            "fax_number": "973-506-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MEDICAL SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "ESCAMILLA",
        "authorized_official_first_name": "KILEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-506-4055"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.