911 Medical Supply Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

911 MEDICAL SUPPLY INC.

Practice address

305 E 4TH St
Suite. A2
Perris, CA 92570-2279

Phone

(951) 940-9009

Fax

(951) 940-9005

NPI assigned

May 13, 2008

Organization subpart

No

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

Authorized official

Name

Amina Yusef-Ismeal

Title

Owner/Ceo

Phone

(951) 940-9009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241136000000",
    "number": "1285801753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E 4TH ST",
            "address_2": "SUITE. A2",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925702279",
            "telephone_number": "951-940-9009",
            "fax_number": "951-940-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E 4TH ST",
            "address_2": "SUITE. A2",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925702279",
            "telephone_number": "951-940-9009",
            "fax_number": "951-940-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "911 MEDICAL SUPPLY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2009-05-01",
        "status": "A",
        "authorized_official_last_name": "YUSEF-ISMEAL",
        "authorized_official_first_name": "AMINA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "951-940-9009"
    },
    "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 Perris, CA
• Providers in Perris, 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 May 1, 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.