Maxi-Med Supples, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MAXI-MED SUPPLES, INC

Practice address

2315 Kuehner Drive
#105
Simi Valley, CA 93063-3960

Phone

(805) 578-8668

NPI assigned

Oct 19, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Alenush Ellen Ayvazyan

Title

Presdent

Phone

(805) 578-8668

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maxi-Med Supples Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366761600000",
    "number": "1962738468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 KUEHNER DRIVE",
            "address_2": "SUITE #105",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633960",
            "telephone_number": "805-978-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 KUEHNER DRIVE",
            "address_2": "#105",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633960",
            "telephone_number": "805-578-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXI-MED SUPPLES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-19",
        "last_updated": "2013-04-24",
        "status": "A",
        "authorized_official_last_name": "AYVAZYAN",
        "authorized_official_first_name": "ALENUSH",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PRESDENT",
        "authorized_official_telephone_number": "805-578-8668",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196738468",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maxi-Med Supples",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Michael Matuszak
• William L. Matzner, M.D., PH.D.
• Cho May, M.D
• Maziar Izadi DDS Inc
• Brenda Margaret McAlpin, PA-C
• Liana L McCoy, LCSW
• Heather K McCune, MD

• Durable Medical Equipment & Medical Supplies in Simi Valley, CA
• Providers in Simi Valley, 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 Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.