Village Medical Supply,LLC.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

332BC3200X Issued in NJ

Legal business name

VILLAGE MEDICAL SUPPLY,LLC.

Practice address

18 Sherwood Dr
Bloomsburg, PA 17815-3085

Phone

(570) 389-1161

Fax

(570) 389-1163

NPI assigned

Dec 15, 2006

Last updated

Aug 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Evelyn Lugo

Title

Owner

Phone

(973) 652-7557

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1780746768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SHERWOOD DR",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178153085",
            "telephone_number": "570-389-1161",
            "fax_number": "570-389-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SHERWOOD DR",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178153085",
            "telephone_number": "570-389-1161",
            "fax_number": "570-389-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE MEDICAL SUPPLY,LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "LUGO",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-652-7557",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NJ",
            "license": "332BC3200X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE CROSS BLUE SHIELD",
            "identifier": "2509434",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "529426",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012127610002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018678",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "39H56",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Bloomsburg, PA
• Providers in Bloomsburg, PA by specialty
• Customized Equipment (DME) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.