Premier Care Medical Supplies Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PREMIER CARE MEDICAL SUPPLIES INC

Practice address

10512 177TH St
Jamaica, NY 11433-1811

Phone

(718) 725-0580

Fax

(718) 725-0581

NPI assigned

May 13, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Abumhenre Kelvin Ukpebor

Title

Ceo

Phone

(718) 725-0580

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1750727103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10512 177TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114331811",
            "telephone_number": "718-725-0580",
            "fax_number": "718-725-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10512 177TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114331811",
            "telephone_number": "718-725-0580",
            "fax_number": "718-725-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARE MEDICAL SUPPLIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "UKPEBOR",
        "authorized_official_first_name": "ABUMHENRE",
        "authorized_official_middle_name": "KELVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-725-0580",
        "authorized_official_name_prefix": "Mr."
    },
    "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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• Durable Medical Equipment & Medical Supplies in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.