3Rd St Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

3RD ST MEDICAL SUPPLY, INC.

Doing business as

Dynamic Repair Network

Practice address

1261 S Lyon St
Suite 05
Santa Ana, CA 92705-4500

Phone

(714) 988-6585

NPI assigned

Mar 31, 2014

Last updated

Jan 23, 2017By 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

Noha M Abdellatif

Title

Ceo

Phone

(714) 988-6585

Specialties & licenses 1

Addresses

Other names 1

• Dynamic Repair Network Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• 3Rd St Medical Supply Inc

  dba Dynamic Repair Solutions

  • Durable Medical Equipment & Medical Supplies
  • Lansing, MI
  • NPI 1013335769

  2769634468

  Same PAC ID
• 3Rd St Medical Supply Inc

  • Durable Medical Equipment & Medical Supplies
  • Houston, TX
  • NPI 1669747390

  2769634468

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

3Rd St Medical Supply Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• 3Rd St Medical Supply Inc

  dba Dynamic Repair Solutions

  • Durable Medical Equipment & Medical Supplies
  • Lansing, MI
  • NPI 1013335769
  NPD tax ID
• 3Rd St Medical Supply Inc

  • Durable Medical Equipment & Medical Supplies
  • Houston, TX
  • NPI 1669747390
  NPD tax ID

Locations

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1710305461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 S LYON ST",
            "address_2": "SUITE 05",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054500",
            "telephone_number": "714-988-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 S LYON ST",
            "address_2": "SUITE 05",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054500",
            "telephone_number": "714-988-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3RD ST MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-31",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "ABDELLATIF",
        "authorized_official_first_name": "NOHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-988-6585"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Repair Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Santa Ana, CA
• Providers in Santa Ana, 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 Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.