Rialto Medical Supplies, Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

101217 Issued in CA

Legal business name

RIALTO MEDICAL SUPPLIES, INC.

Practice address

26598 Pine Ave.
Rimforest, CA 92378

Phone

(909) 744-8067

NPI assigned

Aug 3, 2006

Last updated

Jun 27, 2012By 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. Thomas Alan Cooper

Title

President

Phone

(909) 744-8067

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1356359673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 583",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923520583",
            "telephone_number": "909-744-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26598 PINE AVE.",
            "city": "RIMFOREST",
            "state": "CA",
            "postal_code": "92378",
            "telephone_number": "909-744-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIALTO MEDICAL SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-744-8067",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "CA",
            "license": "101217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ77264Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oxygen Equipment & Supplies (DME) in Rimforest, CA
• Providers in Rimforest, CA by specialty
• Oxygen Equipment & Supplies (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.