Advanced Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ADVANCED MEDICAL SUPPLY INC

Practice address

1621 S Rancho Santa Fe Rd
Ste H
San Marcos, CA 92078-2125

Phone

(760) 510-8096

Fax

(760) 510-8336

NPI assigned

Jun 8, 2005

Organization subpart

No

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

Authorized official

Name

Daniel R Jackson

Title

Owner

Phone

(760) 510-8096

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1730183633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 S RANCHO SANTA FE RD",
            "address_2": "STE H",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782125",
            "telephone_number": "760-510-8096",
            "fax_number": "760-510-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 S RANCHO SANTA FE RD",
            "address_2": "STE H",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782125",
            "telephone_number": "760-510-8096",
            "fax_number": "760-510-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-510-8096"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in San Marcos, CA
• Providers in San Marcos, 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 Jul 21, 2009; 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.