Organization Active NPI

Mendez Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Elk City, OK
National Provider Identifier
1275580623
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MENDEZ MEDICAL, LLC
Doing business as
Mendez Medical, LLC
Practice address
209 W Broadway Ave
Elk City, OK 73644-4741
Phone
(580) 303-9275
Fax
(580) 303-9236
NPI assigned
May 30, 2006
Last updated
May 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Authorized official

Name
Mr. Alex Mendez, RRT
Title
Owner
Phone
(580) 303-9275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X OK Primary

Addresses

Primary practice location

209 W Broadway Ave
Elk City, OK 73644-4741

Mailing address

209 W Broadway Ave
Elk City, OK 73644-4741
Phone (580) 303-9275

Other identifiers 1

IdentifierTypeStateIssuer
100796430AMedicaidOK

Other names 1

  • Mendez Medical, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1275580623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W BROADWAY AVE",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736444741",
            "telephone_number": "580-303-9275",
            "fax_number": "580-303-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W BROADWAY AVE",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736444741",
            "telephone_number": "580-303-9275",
            "fax_number": "580-303-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDEZ MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-303-9275",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RRT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100796430A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mendez Medical, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; 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.