SE Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SE MEDICAL SUPPLY

Practice address

5220 Foggia Ave
Las Vegas, NV 89130-7059

Phone

(702) 330-6693

NPI assigned

Nov 8, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Andre Williams, LPCC

Title

Owner

Phone

(702) 330-6693

Specialties & licenses 1

Addresses

Other names 1

• SE Medical Supply Former legal business name

Electronic endpoints 1

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1689382608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 FOGGIA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891307059",
            "telephone_number": "702-330-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 FOGGIA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891307059",
            "telephone_number": "702-330-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-330-6693",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Awilliamsconsultation@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "5220 Foggia Ave",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891307059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SE Medical Supply",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Durable Medical Equipment & Medical Supplies in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.