Medivance Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDIVANCE SUPPLY LLC

Practice address

1021 E Lincolnway Ste 9967
Cheyenne, WY 82001-4851

Phone

(469) 915-5044

NPI assigned

Mar 6, 2026

Last updated

Apr 2, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Imran Kashif

Title

Authorized Official

Phone

(469) 915-5044

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1772755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1962358523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 E LINCOLNWAY STE 9967",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 E LINCOLNWAY STE 9967",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014851",
            "telephone_number": "469-915-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIVANCE SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-06",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "KASHIF",
        "authorized_official_first_name": "IMRAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "469-915-5044"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medication Management Services Inc
• Medihorizons Inc (Cheyenne Family Medicine)
• Danelle Medina
• Jonathon Dominique Medina, M.D.
• Katherine Beth Medina, SOCIAL SCIENCE, B.S.
• Lisa Elizabeth Meeker, FNP
• Amy M Megason, RN
• Misty L Mejia
• Laurence William Melka, MSW ACSW LCSW
• O'Brien Eileen Mellars, FNP

• Durable Medical Equipment & Medical Supplies in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Durable Medical Equipment & Medical Supplies in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; 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.