Great American Scooter Company Golden Triangle LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GREAT AMERICAN SCOOTER COMPANY GOLDEN TRIANGLE LLC

Practice address

65 N 11TH St
Beaumont, TX 77702-2224

Phone

(409) 833-8300

Fax

(409) 833-8301

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Bobby W Sanders

Title

Owner

Phone

(409) 833-8300

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Great American Medical Supply Doing business as

Locations

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327968000000",
    "number": "1710079983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N 11TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777022224",
            "telephone_number": "409-833-8300",
            "fax_number": "409-833-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N 11TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777022224",
            "telephone_number": "409-833-8300",
            "fax_number": "409-833-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT AMERICAN SCOOTER COMPANY GOLDEN TRIANGLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-01-31",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-833-8300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159927601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159927602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "531789",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great American Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brianna Lee Graffagnino, LMT
• Jordan Brett Graffagnino, LSA, CSFA
• Lacey N Graffagnino, LSA
• Clancie Calais Grant, RPH
• Shawn Rooney Gray, MSN
• Greater Beaumont Oral & Maxillofacial Surgery, PA
• Greater Houston Emergency Physicians PLLC
• Greater Texas Orthopedic Associates, PLLC
• Michael J Grecula, M.D.
• Catalina Green

• Durable Medical Equipment & Medical Supplies in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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.