Simply Divine Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SIMPLY DIVINE MEDICAL SUPPLY

Practice address

3614 Church Ave
Brooklyn, NY 11203-3686

Phone

(347) 405-9182

Fax

(888) 328-0487

NPI assigned

Mar 5, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Jillien K Durrant

Title

President

Phone

(347) 405-9182

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561075200000",
    "number": "1891069068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033686",
            "telephone_number": "347-405-9182",
            "fax_number": "888-328-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033686",
            "telephone_number": "347-405-9182",
            "fax_number": "888-328-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY DIVINE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2019-06-21",
        "status": "A",
        "authorized_official_last_name": "DURRANT",
        "authorized_official_first_name": "JILLIEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-405-9182",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Url",
            "affiliation": "N",
            "endpointDescription": "Url",
            "address_1": "3614 Church Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112033686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Providers in Brooklyn, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.