Odyssey Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

102144 Issued in CA

Legal business name

ODYSSEY MEDICAL SUPPLY

Practice address

14623 Hawthorne Blvd
Suite 106
Lawndale, CA 90260-1581

Phone

(310) 676-2142

Fax

(310) 676-2143

NPI assigned

Aug 21, 2007

Last updated

Mar 12, 2008By 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

Augusta O. Awanyai

Title

President

Phone

(310) 676-2142

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1629261870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14623 HAWTHORNE BLVD",
            "address_2": "SUITE 106",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902601581",
            "telephone_number": "310-676-2142",
            "fax_number": "310-676-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14623 HAWTHORNE BLVD",
            "address_2": "SUITE 106",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902601581",
            "telephone_number": "310-676-2142",
            "fax_number": "310-676-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "AWANYAI",
        "authorized_official_first_name": "AUGUSTA",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-676-2142"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "102144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Lawndale, CA
• Providers in Lawndale, 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 12, 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.