Pomona Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

POMONA MEDICAL SUPPLY, INC.

Practice address

733 E Holt Ave
Pomona, CA 91767-5627

Phone

(909) 623-4378

Fax

(909) 622-2375

NPI assigned

Jul 21, 2010

Last updated

Jun 15, 2011By 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

Mr. John Helliesen

Title

Ceo

Phone

(909) 623-4378

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1508179326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675627",
            "telephone_number": "909-623-4378",
            "fax_number": "909-622-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675627",
            "telephone_number": "909-623-4378",
            "fax_number": "909-622-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POMONA MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "HELLIESEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-623-4378",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ31459Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pomona Orthopedic & Multispecialty Medical Associates, Inc
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• Pomona RX Inc
• Pomona Surgical Supply Co.
• Pomona Surgical Supply Co.

• Durable Medical Equipment & Medical Supplies in Pomona, CA
• Providers in Pomona, 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 15, 2011; 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.