Fastrack Medical Supplies,Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FASTRACK MEDICAL SUPPLIES,INC.

Practice address

7301 N Lincoln Ave
Suite 215
Lincolnwood, IL 60712-1735

Phone

(847) 982-9440

Fax

(847) 982-9442

NPI assigned

Aug 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Henry Balbon Rara

Title

President

Phone

(847) 982-9440

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1497948517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 N LINCOLN AVE",
            "address_2": "SUITE 215",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121709",
            "telephone_number": "847-982-9440",
            "fax_number": "847-982-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 N LINCOLN AVE",
            "address_2": "SUITE 215",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121735",
            "telephone_number": "847-982-9440",
            "fax_number": "847-982-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASTRACK MEDICAL SUPPLIES,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "RARA",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "BALBON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-982-9440",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.