Meridian Medical Resources, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

56288 Issued in CA

Legal business name

MERIDIAN MEDICAL RESOURCES, INC.

Doing business as

Meridian Rehab Care, Meridian Surgical Implants

Practice address

740 W Mill St
Units G & H
San Bernardino, CA 92410-3359

Phone

(800) 320-4259

Fax

(800) 320-4287

NPI assigned

Jul 13, 2012

Last updated

Jul 13, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

PRIME HOLDINGS INTL, INC.As reported in NPPES

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

Authorized official

Name

Mr. Fermin Alexander Iglesias

Title

Ceo/President

Phone

(818) 381-2464

Specialties & licenses 1

Addresses

Other names 1

• Meridian Rehab Care, Meridian Surgical Implants Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1538414743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2040",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924062040",
            "telephone_number": "800-320-4259",
            "fax_number": "800-320-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W MILL ST",
            "address_2": "UNITS G & H",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103359",
            "telephone_number": "800-320-4259",
            "fax_number": "800-320-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN MEDICAL RESOURCES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME HOLDINGS INTL, INC.",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "IGLESIAS",
        "authorized_official_first_name": "FERMIN",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "818-381-2464",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "56288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Rehab Care, Meridian Surgical Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Tamika Celita Merriwether, REGISTERED NURSE MSN
• Amanda Messrah, RPH

• Durable Medical Equipment & Medical Supplies in San Bernardino, CA
• Providers in San Bernardino, 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 Jul 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.