Or- Medical Supply, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

6030540001 Issued in OR

Legal business name

OR- MEDICAL SUPPLY, INC

Practice address

628 N Riverside Ave
Ste. E
Medford, OR 97501-4654

Phone

(541) 245-9940

Fax

(541) 245-9941

NPI assigned

Sep 28, 2007

Last updated

Jul 17, 2008By 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

Toni G Medzhidov

Title

President

Phone

(541) 245-9940

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1972790426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 N RIVERSIDE AVE",
            "address_2": "STE. E",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014654",
            "telephone_number": "541-245-9940",
            "fax_number": "541-245-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 N RIVERSIDE AVE",
            "address_2": "STE. E",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014654",
            "telephone_number": "541-245-9940",
            "fax_number": "541-245-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OR- MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "MEDZHIDOV",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-245-9940"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": "6030540001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.