NPIMap

Organization Active NPI

Western Healthcare Ind Inc

Doing business as northern medical supply company

  • Oxygen Equipment & Supplies (DME)
  • Jackson, CA
National Provider Identifier
1932140332
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
102453 Issued in CA
Legal business name
WESTERN HEALTHCARE IND INC
Doing business as
northern medical supply company
Practice address
825 N State Highway 49-88
Jackson, CA 95642-2041
Phone
(209) 223-7306
Fax
(209) 223-7309
NPI assigned
Jun 9, 2006
Last updated
Aug 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Authorized official

Name
Mr. Vincent Leroy Destigter, RCP 9059NPI 1285679233
Title
Ceo/Owner
Phone
(209) 223-7306

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X 102453 CA Primary

Addresses

Primary practice location

825 N State Highway 49-88
Jackson, CA 95642-2041

Mailing address

825 N State Highway 49-88
P.O.Box 608
Jackson, CA 95642-2041
Phone (209) 223-7306

Other identifiers 1

IdentifierTypeStateIssuer
DME00219FMedicaidCA

Other names 1

  • northern medical supply company Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1932140332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N STATE HIGHWAY 49-88",
            "address_2": "P.O.BOX 608",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422041",
            "telephone_number": "209-223-7306",
            "fax_number": "209-223-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N STATE HIGHWAY 49-88",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422041",
            "telephone_number": "209-223-7306",
            "fax_number": "209-223-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN HEALTHCARE IND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "DESTIGTER",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "209-223-7306",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RCP 9059"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "CA",
            "license": "102453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME00219F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "northern medical supply company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.