Community Durable Medical Equipment

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

6000004713 Issued in PA

Legal business name

COMMUNITY DURABLE MEDICAL EQUIPMENT

Practice address

4706 Blakiston St
Philadelphia, PA 19136-1515

Phone

(215) 331-9812

Fax

(215) 331-9816

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gerard O'Connor

Title

Owner

Phone

(215) 331-9812

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

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": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1760519391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3057 WINCHESTER AVE.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19136",
            "telephone_number": "215-331-9812",
            "fax_number": "215-331-9816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4706 BLAKISTON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191361515",
            "telephone_number": "215-331-9812",
            "fax_number": "215-331-9816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DURABLE MEDICAL EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "GERARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-331-9812",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "PA",
            "license": "6000004713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0002764000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014580451",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015804510003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oxygen Equipment & Supplies (DME) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Oxygen Equipment & Supplies (DME) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.