Athena Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ATHENA MEDICAL SUPPLY LLC

Practice address

2975 Cumberland Rd
Fullerton, CA 92833-5535

Phone

(840) 250-9793

NPI assigned

Jun 22, 2024

Last updated

Jun 22, 2024By 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

Dina Hauser

Title

Owner

Phone

(840) 250-9793

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719014400000",
    "number": "1427892660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 CUMBERLAND RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928335535",
            "telephone_number": "840-250-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 CUMBERLAND RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928335535",
            "telephone_number": "840-250-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "HAUSER",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "840-250-9793"
    },
    "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 Fullerton, CA
• Providers in Fullerton, 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 Jun 22, 2024; 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.