De Divine Connection Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

332B00000X Issued in TX

Legal business name

DE DIVINE CONNECTION MEDICAL SUPPLY INC

Practice address

10200 W Airport Blvd Ste 110
Stafford, TX 77477-3333

Phone

(281) 933-9172

Fax

(281) 933-9172

NPI assigned

Oct 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Atuchi

Title

President

Phone

(281) 933-9162

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1740479369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 W AIRPORT BLVD STE 110",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773333",
            "telephone_number": "281-933-9162",
            "fax_number": "281-933-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 W AIRPORT BLVD STE 110",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773333",
            "telephone_number": "281-933-9172",
            "fax_number": "281-933-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE DIVINE CONNECTION MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "ATUCHI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-933-9162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "332B00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191543101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Stafford, TX
• Providers in Stafford, 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 Feb 8, 2017; 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.