Active NPI
Sacramento Medical Supply LLC
- Durable Medical Equipment & Medical Supplies
- Sacramento, CA
National Provider Identifier
1730025784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- SACRAMENTO MEDICAL SUPPLY LLC
- Practice address
- 1968 Fulton Ave
Sacramento, CA 95825-1906 - Phone
- (916) 212-2323
- NPI assigned
- Apr 23, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Johnnie B Nolen
- Title
- Ceo/Owner
- Phone
- (916) 212-2323
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
1968 Fulton Ave
Sacramento, CA 95825-1906
Mailing address
1968 Fulton Ave
Sacramento, CA 95825-1906
Phone (916) 212-2323
National Provider Directory
National Provider DirectoryLocations
1968 Fulton Ave
Sacramento, CA 95825
Phone (916) 212-2323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776988800000",
"number": "1730025784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1968 FULTON AVE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958251906",
"telephone_number": "916-212-2323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1968 FULTON AVE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958251906",
"telephone_number": "916-212-2323"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SACRAMENTO MEDICAL SUPPLY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-04-23",
"last_updated": "2026-04-24",
"certification_date": "2026-04-24",
"status": "A",
"authorized_official_last_name": "NOLEN",
"authorized_official_first_name": "JOHNNIE",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "916-212-2323"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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- Sacramento Midtown Endoscopy Center, LLC
- Sacramento Native American Health Center Inc
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.