Revolution Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

REVOLUTION MEDICAL SUPPLY, LLC

Practice address

571 Crane St
Unit H
Lake Elsinore, CA 92530-2742

Phone

(951) 471-1122

Fax

(951) 471-1123

NPI assigned

Jun 9, 2015

Organization subpart

No

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

Authorized official

Name

Lisa Marie Espinoza

Title

Owner

Phone

(951) 471-1122

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1508246133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 CRANE ST",
            "address_2": "UNIT H",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302742",
            "telephone_number": "951-471-1122",
            "fax_number": "951-471-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 CRANE ST",
            "address_2": "UNIT H",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302742",
            "telephone_number": "951-471-1122",
            "fax_number": "951-471-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "ESPINOZA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-471-1122"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Lake Elsinore, CA
• Providers in Lake Elsinore, 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 9, 2015; 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.