Organization Active NPI

First Supply Service Corp

  • Family Medicine Physician
  • Raleigh, NC
National Provider Identifier
1780478735
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FIRST SUPPLY SERVICE CORP
Practice address
2900 Highwoods Blvd Ste 200
Raleigh, NC 27604-1036
Phone
(239) 414-6021
NPI assigned
Apr 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Authorized official

Name
Pedro Erquiaga Calderon
Title
Owner
Phone
(239) 414-6021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2900 Highwoods Blvd Ste 200
Raleigh, NC 27604-1036

Mailing address

2900 Highwoods Blvd Ste 200
Raleigh, NC 27604-1036
Phone (239) 414-6021

National Provider Directory

National Provider Directory
Tax ID family
First Supply Service Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2900 Highwoods Blvd
Ste 200
Raleigh, NC 27604
Phone (239) 414-6021

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1780478735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 HIGHWOODS BLVD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041036",
            "telephone_number": "239-414-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 HIGHWOODS BLVD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041036",
            "telephone_number": "239-414-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST SUPPLY SERVICE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-06",
        "status": "A",
        "authorized_official_last_name": "ERQUIAGA CALDERON",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-414-6021"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.