Advance Medical Supply

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

17439 Issued in CA

Legal business name

ADVANCE MEDICAL SUPPLY

Practice address

22810 Alessandro Blvd
Suite a
Moreno Valley, CA 92553-8549

Phone

(951) 653-9710

Fax

(951) 653-9719

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Maria Teresa Mejia

Title

Owner

Phone

(951) 653-9710

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295882058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22810 ALESSANDRO BLVD",
            "address_2": "SUITE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538549",
            "telephone_number": "951-653-9710",
            "fax_number": "951-653-9719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22810 ALESSANDRO BLVD",
            "address_2": "SUITE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538549",
            "telephone_number": "951-653-9710",
            "fax_number": "951-653-9719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEJIA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-653-9710"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "17439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Customized Equipment (DME) in California

• 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.