Club Med LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CLUB MED LLC

Practice address

7259 Mansfield Ave
Philadelphia, PA 19138-1620

Phone

(888) 554-8850

Fax

(877) 829-6012

NPI assigned

Feb 23, 2011

Last updated

Feb 23, 2011By 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

Ms. Patrice L Fate

Title

DME Supplyer

Phone

(888) 554-8850

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298419200000",
    "number": "1396042552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7259 MANSFIELD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191381620",
            "telephone_number": "888-554-8850",
            "fax_number": "877-829-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7259 MANSFIELD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191381620",
            "telephone_number": "888-554-8850",
            "fax_number": "877-829-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLUB MED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-23",
        "last_updated": "2011-02-23",
        "status": "A",
        "authorized_official_last_name": "FATE",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DME SUPPLYER",
        "authorized_official_telephone_number": "888-554-8850",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Durable Medical Equipment & Medical Supplies in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.