Vista Healthcare Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

VISTA HEALTHCARE SUPPLY

Practice address

2573 E 7TH Ave
Flagstaff, AZ 86004-3722

Phone

(928) 522-0507

Fax

(928) 522-9324

NPI assigned

Apr 6, 2011

Organization subpart

No

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

Authorized official

Name

Jonathan Andrew Hovey

Title

Owner/Operator

Phone

(928) 522-0507

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1912296336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2573 E 7TH AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043722",
            "telephone_number": "928-522-0507",
            "fax_number": "928-522-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2573 E 7TH AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043722",
            "telephone_number": "928-522-0507",
            "fax_number": "928-522-9324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA HEALTHCARE SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "HOVEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "928-522-0507"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.