Bethany Medical Supply Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

332B00000X Issued in CA

Legal business name

BETHANY MEDICAL SUPPLY INC.

Practice address

525 N Azusa Ave Ste 111
La Puente, CA 91744-4261

Phone

(626) 961-8699

Fax

(626) 961-8806

NPI assigned

Jun 29, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Hibest Essayas

Title

Ceo President

Phone

(626) 961-8699

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1477581544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N AZUSA AVE STE 111",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917444261",
            "telephone_number": "626-961-8699",
            "fax_number": "626-961-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N AZUSA AVE STE 111",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917444261",
            "telephone_number": "626-961-8699",
            "fax_number": "626-961-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY MEDICAL SUPPLY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "ESSAYAS",
        "authorized_official_first_name": "HIBEST",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "626-961-8699",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "332B00000X",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "CA",
            "license": "103509",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199939",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CROSS OVER MEDICAL",
            "identifier": "DME03250F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in La Puente, CA
• Providers in La Puente, 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 Aug 9, 2012; 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.