Organization Active NPI

WNC Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Fremont, CA
National Provider Identifier
1417126780
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
WNC MEDICAL SUPPLY LLC
Practice address
3705 Beacon Ave Ste 200
Fremont, CA 94538-1467
Phone
(510) 796-5555
Fax
(510) 796-7044
NPI assigned
Feb 20, 2008
Last updated
Feb 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Ms. Lolita Lydia Sharp
Title
Owner
Phone
(408) 335-8744

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Prosthetic/Orthotic Supplier 335E00000X NU

Addresses

Primary practice location

3705 Beacon Ave Ste 200
Fremont, CA 94538-1467

Mailing address

3705 Beacon Ave Ste 200
Fremont, CA 94538-1467
Phone (510) 796-5555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1417126780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 BEACON AVE STE 200",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381467",
            "telephone_number": "510-796-5555",
            "fax_number": "510-796-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 BEACON AVE STE 200",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381467",
            "telephone_number": "510-796-5555",
            "fax_number": "510-796-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WNC MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "LOLITA",
        "authorized_official_middle_name": "LYDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-335-8744",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.