Proforma Medical Sourc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROFORMA MEDICAL SOURC

Practice address

800 N Rainbow Blvd
Ste 215
Las Vegas, NV 89107-1189

Phone

(800) 875-8455

Fax

(702) 948-7616

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

Marie Villanueva

Title

Vice President

Phone

(800) 875-8455

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217548800000",
    "number": "1962429621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD",
            "address_2": "STE 215",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071189",
            "telephone_number": "800-875-8455",
            "fax_number": "702-948-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD",
            "address_2": "STE 215",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071189",
            "telephone_number": "800-875-8455",
            "fax_number": "702-948-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFORMA MEDICAL SOURC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "800-875-8455"
    },
    "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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• Progressive Home Health Care, Inc.

• Durable Medical Equipment & Medical Supplies in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Durable Medical Equipment & Medical Supplies in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; 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.