Prestige Enterprise a Medical Supply Co.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

332B0000X Issued in CA

Legal business name

PRESTIGE ENTERPRISE A MEDICAL SUPPLY CO.

Practice address

1113 W Gardena Blvd
Suite a
Gardena, CA 90247-4887

Phone

(310) 515-0979

Fax

(310) 515-1290

NPI assigned

Aug 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Godfrey U. Nwogene

Title

President

Phone

(310) 515-0979

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1356354807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 W GARDENA BLVD",
            "address_2": "SUITE A",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474887",
            "telephone_number": "310-515-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 W GARDENA BLVD",
            "address_2": "SUITE A",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474887",
            "telephone_number": "310-515-0979",
            "fax_number": "310-515-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE ENTERPRISE A MEDICAL SUPPLY CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "NWOGENE",
        "authorized_official_first_name": "GODFREY",
        "authorized_official_middle_name": "U.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-515-0979",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "332B0000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalen Michelle Prayer, LCSW
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• Phoenicia Preston
• Katherine Preza Leonor
• Xitlali Prianti

• Durable Medical Equipment & Medical Supplies in Gardena, CA
• Providers in Gardena, 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 Oct 29, 2008; 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.