Glendale Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GLENDALE MEDICAL SUPPLY

Practice address

5415 W Glendale Ave
Glendale, AZ 85301-2621

Phone

(623) 934-4301

Fax

(623) 934-4364

NPI assigned

Dec 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ilya Sokolov

Title

Owner

Phone

(623) 934-4301

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275699324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 W GLENDALE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853012621",
            "telephone_number": "623-934-4301",
            "fax_number": "623-934-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 W GLENDALE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853012621",
            "telephone_number": "623-934-4301",
            "fax_number": "623-934-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOKOLOV",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-934-4301",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.