Prudent Medical Supplies Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

74463 Issued in CA

Legal business name

PRUDENT MEDICAL SUPPLIES INC

Practice address

5250 W Century Blvd
Suite 216
Los Angeles, CA 90045-5972

Phone

(424) 331-5400

Fax

(424) 331-5933

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Bruck Mengistu

Title

President

Phone

(424) 331-5400

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": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1770954471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 W CENTURY BLVD",
            "address_2": "SUITE 216",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455972",
            "telephone_number": "424-331-5400",
            "fax_number": "424-331-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 W CENTURY BLVD",
            "address_2": "SUITE 216",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455972",
            "telephone_number": "424-331-5400",
            "fax_number": "424-331-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENT MEDICAL SUPPLIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "MENGISTU",
        "authorized_official_first_name": "BRUCK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "424-331-5400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "74463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerome Prudencio Jr.
• Naytzari Jacqueline Prudencio
• Prudent Decisions Inc. (Pd Hospice)
• Prudent Home Health Care, Inc.
• Prudent Medical Group, Inc.
• Abel Prudhomme
• Jonathan L Pruett
• Jay D. Pruetz, M.D.
• Geone Pruitt, COUNSELOR
• Jasmin J Pruitt

• Durable Medical Equipment & Medical Supplies in Los Angeles, CA
• Providers in Los Angeles, 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 Apr 19, 2017; 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.