Destiny Medical Supplies Inc.,

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0055999 Issued in TX

Legal business name

DESTINY MEDICAL SUPPLIES INC.,

Practice address

4735 E Lancaster Ave
Fort Worth, TX 76103-3835

Phone

(817) 534-2770

Fax

(817) 534-2977

NPI assigned

Jun 21, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Paul Bassey

Title

Ceo

Phone

(817) 534-2770

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366448797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51088",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761058088",
            "telephone_number": "817-534-2770",
            "fax_number": "817-534-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 E LANCASTER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033835",
            "telephone_number": "817-534-2770",
            "fax_number": "817-534-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY MEDICAL SUPPLIES INC.,",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASSEY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-534-2770",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0055999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP ID#",
            "identifier": "102881",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• 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.