Divine Medical Supplies, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DIVINE MEDICAL SUPPLIES, INC

Practice address

7070 Upper 157TH St W
Apple Valley, MN 55124-5121

Phone

(714) 225-4762

Fax

(714) 930-9435

NPI assigned

Jul 13, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Femi Abatan

Title

President

Phone

(714) 225-4762

Specialties & licenses 2

Addresses

Other names 1

• Divine Medical Supply Doing business as

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310515200000",
    "number": "1538457346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7070 UPPER 157TH ST W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245121",
            "telephone_number": "714-225-4762",
            "fax_number": "714-930-9435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7070 UPPER 157TH ST W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245121",
            "telephone_number": "714-225-4762",
            "fax_number": "714-930-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE MEDICAL SUPPLIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-13",
        "last_updated": "2011-07-13",
        "status": "A",
        "authorized_official_last_name": "ABATAN",
        "authorized_official_first_name": "FEMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-225-4762",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David P Dillon, MD
• Mariana G Dimitrova Hart, M.D.
• Said Abdi Dirie
• Eleyeh Hamoud Dirieh
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• Thanh DO
• Sarah A Doll, LPCC
• Douglas E Dooley, LICSW
• Mary Patricia Dourgarian, MD
• Jenna Lynn Doyle, RN, BSN

• All providers in Apple Valley, MN
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.