Blueline Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BLUELINE MEDICAL SUPPLY LLC

Practice address

2061 NW 2ND Ave Ste 102
Boca Raton, FL 33431-6774

Phone

(561) 571-6042

NPI assigned

Jul 2, 2020

Last updated

Nov 23, 2020By 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

Gerson Petigny

Title

Owner

Phone

(561) 571-6042

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1558988824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 NW 2ND AVE STE 102",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316774",
            "telephone_number": "561-571-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 NW 2ND AVE STE 102",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316774",
            "telephone_number": "561-571-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUELINE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "PETIGNY",
        "authorized_official_first_name": "GERSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-571-6042"
    },
    "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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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.