Park Medical Wear, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PARK MEDICAL WEAR, INC.

Practice address

1697 Freedom CT
Henderson, NV 89014-7526

Phone

(866) 699-9612

Fax

(702) 405-7147

NPI assigned

May 17, 2011

Organization subpart

No

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

Authorized official

Name

Michael David Park

Title

President

Phone

(866) 699-9612

Specialties & licenses 1

Addresses

Other names 1

• Park Mastectomy Supply Doing business as

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1821381328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1697 FREEDOM CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147526",
            "telephone_number": "866-699-9612",
            "fax_number": "702-405-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1697 FREEDOM CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147526",
            "telephone_number": "866-699-9612",
            "fax_number": "702-405-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK MEDICAL WEAR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-17",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-699-9612"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Mastectomy Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rupesh J Parikh, MD
• Leonard D. Parilak, M.D.
• Parish Starrae Health LLC
• Deokchol Parish, FNP-BC
• Park Family Eyecare Inc.
• Hyo-Jong Park, M.D.
• Jasmin Dahyun Park
• Jaime Parke, CRNA
• Angelique Parker
• Caitlin Brianna Parker, MS, RD

• Prosthetic/Orthotic Supplier in Henderson, NV
• Providers in Henderson, NV by specialty
• Prosthetic/Orthotic Supplier in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.