NPIMap

Organization Active NPI

Mountain Peaks Medical Supplies, Inc.

Doing business as Prime Care Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Albany, NY
National Provider Identifier
1790012722
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MOUNTAIN PEAKS MEDICAL SUPPLIES, INC.
Doing business as
Prime Care Medical Equipment
Practice address
16 Walker Way
Albany, NY 12205-4995
Phone
(518) 456-6192
Fax
(518) 456-6193
NPI assigned
Nov 12, 2009
Last updated
Feb 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Authorized official

Name
Mr. John A Hyde
Title
Vice President
Phone
(518) 456-6192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

16 Walker Way
Albany, NY 12205-4995

Mailing address

16 Walker Way
Albany, NY 12205-4995
Phone (518) 456-6192

Other identifiers 1

IdentifierTypeStateIssuer
03106145MedicaidNY

Other names 1

  • Prime Care Medical Equipment Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mountain Peaks Medical Supplies Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1790012722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WALKER WAY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054995",
            "telephone_number": "518-456-6192",
            "fax_number": "518-456-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WALKER WAY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054995",
            "telephone_number": "518-456-6192",
            "fax_number": "518-456-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN PEAKS MEDICAL SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "HYDE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "518-456-6192",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03106145",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Care Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.