Organization Active NPI

Alfred Kpekpe

  • Durable Medical Equipment & Medical Supplies
  • Los Angeles, CA
National Provider Identifier
1568438315
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ALFRED KPEKPE
Doing business as
Devine Healthcare & Medical Supply
Practice address
1807 W 108TH St
Los Angeles, CA 90047-4417
Phone
(323) 777-2797
Fax
(323) 777-2754
NPI assigned
Feb 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Mr. Alfred Kpekpe
Title
Owner
Phone
(323) 777-2797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X CA Primary

Addresses

Primary practice location

1807 W 108TH St
Los Angeles, CA 90047-4417

Mailing address

1807 W 108TH Street
Los Angeles, CA 90047-4417
Phone (323) 777-2797

Other identifiers 1

IdentifierTypeStateIssuer
DME03383FMedicaidCA

Other names 1

  • Devine Healthcare & Medical Supply Doing business as

National Provider Directory

National Provider Directory

Locations

1807 W 108th St
Los Angeles, CA 90047
Phone (323) 777-2797

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1568438315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 W 108TH STREET",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900474417",
            "telephone_number": "323-777-2797",
            "fax_number": "323-777-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W 108TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900474417",
            "telephone_number": "323-777-2797",
            "fax_number": "323-777-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALFRED KPEKPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "KPEKPE",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-777-2797",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME03383F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devine Healthcare & Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.