Avasco Medical Supply Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

396218-03 Issued in CA

Legal business name

AVASCO MEDICAL SUPPLY INC.

Doing business as

Avasco Medical Supply Inc

Practice address

690 East Los Angeles Ave.
Suite D
Simi Valley, CA 93065-7503

Phone

(805) 522-5333

Fax

(805) 522-6333

NPI assigned

Jun 1, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Randy Ababseh

Title

Owner

Phone

(805) 522-5333

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Avasco Medical Supply Inc Doing business as

Locations

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1326040502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 EAST LOS ANGELES AVE.",
            "address_2": "SUITE D",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657503",
            "telephone_number": "805-522-5333",
            "fax_number": "805-522-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 EAST LOS ANGELES AVE.",
            "address_2": "SUITE D",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657503",
            "telephone_number": "805-522-5333",
            "fax_number": "805-522-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVASCO MEDICAL SUPPLY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "ABABSEH",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-522-5333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "396218-03",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "CA",
            "license": "100631",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "396218-03",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF CALIFORNIA",
            "identifier": "954360666",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DOL OWCP PROVIDER ID",
            "identifier": "103377300",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME02516F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avasco Medical Supply Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dionne Melody Austria, FNP-BC, FNP-C
• Maria Dolores Chua Austria, DDS
• Vanessa Avalos
• Sargis Avanesyan, RPH
• Jeffrey Alan Avants, MA, LMFT, CADC II,
• Avasco Medical Supply, Inc
• Avia Home Healthcare Inc.
• Brittney Rena Ayers, NURSE PRACTITIONER
• Madlen Ayvazian, LCSW
• Yelena Ayzenberg, PHARM D

• Durable Medical Equipment & Medical Supplies in Simi Valley, CA
• Providers in Simi Valley, 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 Apr 3, 2012; 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.