A-1 Medical Supply LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

PENDING Issued in NJ

Legal business name

A-1 MEDICAL SUPPLY LLC

Practice address

681 Lawlins Rd
Bay 50 Suite 104
Wyckoff, NJ 07481-1449

Phone

(201) 891-3000

Fax

(201) 891-3001

NPI assigned

Dec 20, 2010

Last updated

Dec 20, 2010By 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

Mr. Blaise Benevenga

Title

Owner / Managing Memebers

Phone

(201) 891-3000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1851694400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 LAWLINS RD",
            "address_2": "BAY 50 SUITE 104",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811449",
            "telephone_number": "201-891-3000",
            "fax_number": "201-891-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 LAWLINS RD",
            "address_2": "BAY 50 SUITE 104",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811449",
            "telephone_number": "201-891-3000",
            "fax_number": "201-891-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A-1 MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-20",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "BENEVENGA",
        "authorized_official_first_name": "BLAISE",
        "authorized_official_title_or_position": "OWNER / MANAGING MEMEBERS",
        "authorized_official_telephone_number": "201-891-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NJ",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Wyckoff, NJ
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• Customized Equipment (DME) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.