Organization Active NPI

Amma Medical Supply and Equipment, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Moreno Valley, CA
National Provider Identifier
1407974124
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
09152 Issued in CA
Legal business name
AMMA MEDICAL SUPPLY AND EQUIPMENT, INC.
Practice address
23932 Alessandro Blvd Ste E
Moreno Valley, CA 92553-8808
Phone
(951) 656-7209
Fax
(951) 656-7239
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Melvin Beluso Marte
Title
President
Phone
(951) 656-7209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 09152 CA Primary

Addresses

Primary practice location

23932 Alessandro Blvd Ste E
Moreno Valley, CA 92553-8808

Mailing address

23932 Alessandro Blvd Ste E
Moreno Valley, CA 92553-8808
Phone (951) 656-7209

Other identifiers 1

IdentifierTypeStateIssuer
DME02761GMedicaidCA

National Provider Directory

National Provider Directory

Locations

23932 Alessandro Blvd
Ste E
Moreno Valley, CA 92553
Phone (951) 656-7209

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407974124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23932 ALESSANDRO BLVD STE E",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538808",
            "telephone_number": "951-656-7209",
            "fax_number": "951-656-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23932 ALESSANDRO BLVD STE E",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538808",
            "telephone_number": "951-656-7209",
            "fax_number": "951-656-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMMA MEDICAL SUPPLY AND EQUIPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTE",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "BELUSO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-656-7209"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "09152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME02761G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • 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.