Clement Etinayagomwan Aghedo

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CLEMENT ETINAYAGOMWAN AGHEDO

Doing business as

Ace Medical Equipment Supply Company

Practice address

248 E Highland Ave
Suite #2
San Bernardino, CA 92404-3703

Phone

(909) 882-2640

Fax

(909) 882-2648

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Clement Etinayagomwan Aghedo

Title

Director

Phone

(909) 882-2640

Specialties & licenses 1

Addresses

Other names 1

• Ace Medical Equipment Supply Company Doing business as

Locations

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1760507248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923770129",
            "telephone_number": "909-882-2640",
            "fax_number": "909-882-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 E HIGHLAND AVE",
            "address_2": "SUITE #2",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043703",
            "telephone_number": "909-882-2640",
            "fax_number": "909-882-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMENT ETINAYAGOMWAN AGHEDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "AGHEDO",
        "authorized_official_first_name": "CLEMENT",
        "authorized_official_middle_name": "ETINAYAGOMWAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "909-882-2640"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ace Medical Equipment Supply Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in San Bernardino, CA
• Providers in San Bernardino, 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 May 14, 2008; 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.