Sante Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SANTE MEDICAL SUPPLY LLC

Doing business as

D.B.A. St. Jude Medical Equipment and Supply

Practice address

1284 Paredes Line
Suite 1
Brownsville, TX 78521-1715

Phone

(956) 542-1988

Fax

(956) 542-0988

NPI assigned

Oct 14, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Graciela Guerra

Title

Owner

Phone

(956) 542-1988

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• D.B.A. St. Jude Medical Equipment and Supply Doing business as

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270080000000",
    "number": "1881784155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1284 PAREDES LINE",
            "address_2": "SUITE 1",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785211715",
            "telephone_number": "956-542-1988",
            "fax_number": "956-542-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1284 PAREDES LINE",
            "address_2": "SUITE 1",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785211715",
            "telephone_number": "956-542-1988",
            "fax_number": "956-542-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-14",
        "last_updated": "2010-04-01",
        "status": "A",
        "authorized_official_last_name": "GUERRA",
        "authorized_official_first_name": "GRACIELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-542-1988",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101608",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175275002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175275001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D.B.A. St. Jude Medical Equipment and Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.