1St Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

1ST MEDICAL SUPPLY

Practice address

12639 Hoover St
Garden Grove, CA 92841-4172

Phone

(866) 737-9397

Fax

(866) 229-1060

NPI assigned

Mar 29, 2010

Organization subpart

Yes

Parent organization

1ST MEDICAL SUPPLYAs reported in NPPES

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

Authorized official

Name

Tatyana V White

Title

Owner/President

Phone

(866) 737-9397

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

1St Medical Supply

Locations

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1619292018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12639 HOOVER ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928414172",
            "telephone_number": "866-737-9397",
            "fax_number": "866-229-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12639 HOOVER ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928414172",
            "telephone_number": "866-737-9397",
            "fax_number": "866-229-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST MEDICAL SUPPLY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "1ST MEDICAL SUPPLY",
        "enumeration_date": "2010-03-29",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "TATYANA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "866-737-9397"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "S12302",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 12072 Trask, Inc.
• 12232 Chapman Ave Inc
• 12882 Shackelford Lane Inc
• 13075 Blackbird Street Opco, LLC
• 2 Steps Away, Inc.
• 2 Steps Away, Inc.
• 365 Medical Group, Inc
• 3Titan Medical Inc
• 4 U Dental

• Durable Medical Equipment & Medical Supplies in Garden Grove, CA
• Providers in Garden Grove, 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 Mar 5, 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.