Valley Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

VALLEY MEDICAL SUPPLY

Practice address

317 Colorado Ave
La Junta, CO 81050

Phone

(719) 384-1888

Fax

(719) 384-1890

NPI assigned

Oct 2, 2007

Reactivated

Jun 16, 2009

Last updated

Jun 16, 2009By 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. Russell Alvin McDonald

Title

Sole Proprietor

Phone

(719) 384-1888

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1366639494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 COLORADO AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "81050",
            "telephone_number": "719-384-1888",
            "fax_number": "719-384-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 COLORADO AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "81050",
            "telephone_number": "719-384-1888",
            "fax_number": "719-384-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2009-06-16",
        "deactivation_date": "2008-06-03",
        "reactivation_date": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "ALVIN",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "719-384-1888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36570371",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gloria Trujillo
• Nicky R Turner, FNP
• Shadoe Underwood, M.S., L.P.C., N.C.C
• Martin Valdez
• Valley Community Counseling Services, LLC
• Valley-Wide Health System, Inc.
• Valley-Wide Health Systems, Inc (La Junta Clinic)
• Valley-Wide Health Systems, Inc. (Valley-Wide at Southeast)
• Valley-Wide Health Systems, Inc.
• Valley-Wide Health Systems, Inc. (Valley-Wide Regional Assessment Center- La Junta)

• Durable Medical Equipment & Medical Supplies in La Junta, CO
• Providers in La Junta, CO by specialty
• Durable Medical Equipment & Medical Supplies in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.