I&M Grand Medical Supplies

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

20174034 Issued in AZ

Legal business name

I&M GRAND MEDICAL SUPPLIES

Practice address

5826 W Olive Ave Ste 102
Glendale, AZ 85302-3153

Phone

(623) 934-3752

Fax

(623) 934-3725

NPI assigned

Jul 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Ivan Manucharyan

Title

Owner

Phone

(623) 934-3752

Specialties & licenses 1

Addresses

Other names 1

• IVAN MANUCHARYAN Doing business as

Locations

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1437359676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5826 W OLIVE AVE STE 102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853023153",
            "telephone_number": "623-934-3752",
            "fax_number": "623-934-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5826 W OLIVE AVE STE 102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853023153",
            "telephone_number": "623-934-3752",
            "fax_number": "623-934-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I&M GRAND MEDICAL SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "MANUCHARYAN",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-934-3752",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "20174034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IVAN MANUCHARYAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; 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.