Broadway Medical Service & Supply, Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

332BX2000X Issued in CA

Legal business name

BROADWAY MEDICAL SERVICE & SUPPLY, INC

Practice address

1034 Broadway St
Eureka, CA 95501-0126

Phone

(707) 442-3719

Fax

(707) 442-0237

NPI assigned

Jan 16, 2007

Organization subpart

Yes

Parent organization

DARR-B CORPAs reported in NPPES

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

Authorized official

Name

Mr. Ronald A Biasca

Title

President

Phone

(707) 442-3719

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1457402497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 BROADWAY ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010126",
            "telephone_number": "707-442-3719",
            "fax_number": "707-442-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 BROADWAY ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010126",
            "telephone_number": "707-442-3719",
            "fax_number": "707-442-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY MEDICAL SERVICE & SUPPLY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DARR-B CORP",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "BIASCA",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-442-3719",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "CA",
            "license": "332BX2000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457402497",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilyn Bell Brende, OTR/L
• Marcia Brenta
• John P Brimlow, PAC
• Marco Brine
• Denise Britain, LVN
• Cyanne Brocious, R.N.
• Joyce Brodie, RN
• Angeline Brom
• Mark Anthony Brooks Jr.
• Joseph Michael Brosnan, D.C.

• Oxygen Equipment & Supplies (DME) in Eureka, CA
• Providers in Eureka, CA by specialty
• Oxygen Equipment & Supplies (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.