Proline Med Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROLINE MED SUPPLY LLC

Practice address

2667 Camino del Rio S Ste 101
San Diego, CA 92108-3763

Phone

(877) 352-1903

NPI assigned

Apr 21, 2020

Organization subpart

No

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

Authorized official

Name

Ruben Santa Cruz Sr.

Title

President

Phone

(877) 352-1903

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1952921850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 TAMIAMI TRL S STE 603F",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853568",
            "telephone_number": "941-809-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2667 CAMINO DEL RIO S STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083763",
            "telephone_number": "877-352-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLINE MED SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "SANTA CRUZ",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "877-352-1903",
        "authorized_official_name_suffix": "Sr."
    },
    "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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• Durable Medical Equipment & Medical Supplies in San Diego, CA
• Providers in San Diego, 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 Sep 22, 2020; 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.