NPIMap

Organization Active NPI

Benniemax Medical Supply Co.

  • Durable Medical Equipment & Medical Supplies
  • Los Angeles, CA
National Provider Identifier
1639114135
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
3852080001 Issued in CA
Legal business name
BENNIEMAX MEDICAL SUPPLY CO.
Practice address
1644 Wilshire Blvd
Suite 105
Los Angeles, CA 90017-1600
Phone
(213) 413-8508
Fax
(213) 413-8509
NPI assigned
Jun 18, 2006
Last updated
Jul 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Mr. Bethram Ogoke
Title
Owner
Phone
(213) 413-8508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 3852080001 CA Primary

Addresses

Primary practice location

1644 Wilshire Blvd
Suite 105
Los Angeles, CA 90017-1600

Mailing address

1644 Wilshire Blvd
Suite 105
Los Angeles, CA 90017-1600
Phone (213) 413-8508

National Provider Directory

National Provider Directory
Tax ID family
Benniemax Medical Supply Co2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1644 Wilshire Blvd
Ste 105
Los Angeles, CA 90017
Phone (213) 413-8508

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1639114135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 WILSHIRE BLVD",
            "address_2": "SUITE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171600",
            "telephone_number": "213-413-8508",
            "fax_number": "213-413-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 WILSHIRE BLVD",
            "address_2": "SUITE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171600",
            "telephone_number": "213-413-8508",
            "fax_number": "213-413-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNIEMAX MEDICAL SUPPLY CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "OGOKE",
        "authorized_official_first_name": "BETHRAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-413-8508",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "3852080001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 9, 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.