Premier Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

56332 Issued in CA

Legal business name

PREMIER MEDICAL SUPPLY, INC.

Practice address

900 N Market Blvd
Suite H
Sacramento, CA 95834-1264

Phone

(916) 646-1600

Fax

(916) 646-1616

NPI assigned

Oct 27, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Alan Francis Bettencourt

Title

Vice-President

Phone

(209) 537-2882

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1891071387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N MARKET BLVD",
            "address_2": "SUITE H",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341264",
            "telephone_number": "916-646-1600",
            "fax_number": "916-646-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N MARKET BLVD",
            "address_2": "SUITE H",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341264",
            "telephone_number": "916-646-1600",
            "fax_number": "916-646-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "BETTENCOURT",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "209-537-2882",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "56332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL DEVICE RETAILER",
            "identifier": "56332",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.