Med Choice One Medical Group and Supplier LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

20064003 Issued in AZ

Legal business name

MED CHOICE ONE MEDICAL GROUP AND SUPPLIER LLC

Practice address

635 W Indian School Rd
Suite 101B
Phoenix, AZ 85013-3117

Phone

(602) 266-4633

Fax

(602) 266-4634

NPI assigned

Aug 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Akaninyene W Etuk

Title

Manager

Phone

(602) 266-4633

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326152653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W INDIAN SCHOOL RD",
            "address_2": "SUITE 101B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133117",
            "telephone_number": "602-266-4633",
            "fax_number": "602-266-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W INDIAN SCHOOL RD",
            "address_2": "SUITE 101B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133117",
            "telephone_number": "602-266-4633",
            "fax_number": "602-266-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED CHOICE ONE MEDICAL GROUP AND SUPPLIER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ETUK",
        "authorized_official_first_name": "AKANINYENE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-266-4633",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "20064003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Phoenix, AZ
• Providers in Phoenix, 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.