Tricore Med Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

TRICORE MED SUPPLY LLC

Practice address

2169 Harbor St
Pittsburg, CA 94565-5013

Phone

(510) 691-2694

NPI assigned

Feb 16, 2023

Organization subpart

No

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

Authorized official

Name

Jericho G Valera

Title

Owner

Phone

(360) 223-0270

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1417655788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2169 HARBOR ST",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945655013",
            "telephone_number": "510-691-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2169 HARBOR ST",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945655013",
            "telephone_number": "510-691-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICORE MED SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "VALERA",
        "authorized_official_first_name": "JERICHO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-223-0270"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Pittsburg, CA
• Providers in Pittsburg, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.