ACTIVE LIFE MEDICAL PRODUTCS INC (NPI# 1225435308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225435308 |
| Entity Type | Organization |
| Organization Name | ACTIVE LIFE MEDICAL PRODUTCS INC |
| Practice Address |
611 W Grider Way Stockton CA 95210 |
| Mailing Address |
4217 Coronado Ave Unit D Stockton CA 95204-2335 |
| Practice Telephone | 2099432118 |
| Practice Fax Number | 2099391212 |
| Mailing Telephone | 2099432118 |
| Mailing Fax Number | 2099391212 |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |
| Authorized Official Name | ARA KARAMANOUKIAN (PRESIDENT) |
| Authorized Official Telephone | 2099432118 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
CA | Suppliers | |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 6252450001 | 05 |
| Street Address |
611 W GRIDER WAY |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| 1316116890 | Rami Georgies | Family Medicine | 8001 Lorraine Ave, Stockton, CA 95210 | 2008-02-28 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801081 | Telegenx, LLC | Durable Medical Equipment & Medical Supplies | 127 S Locust St, Stockton, CA 95205 | 2020-08-12 |
| 1396360194 | Coast To Coast Dme | Durable Medical Equipment & Medical Supplies | 1755 W Hammer Ln Ste 2, Stockton, CA 95209-2900 | 2020-06-08 |
| 1871134940 | Care Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 1325 N Center St Ste 1a, Stockton, CA 95202-1020 | 2019-09-30 |
| 1922575059 | Naju Dah Dme Medical Corporation | Durable Medical Equipment & Medical Supplies | 2800 N California St Ste 17, Stockton, CA 95204-3759 | 2018-10-26 |
| 1649526682 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2040 E Mariposa Rd, Stockton, CA 95205-7736 | 2012-07-27 |
| 1023373495 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 1189 E March Ln, Stockton, CA 95210-3545 | 2012-07-11 |
| 1770842940 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 10355 Trinity Pkwy, Stockton, CA 95219-7243 | 2012-05-09 |
| 1568737161 | Citizens Memorial Health Care Foundation | Durable Medical Equipment & Medical Supplies | 1521 S 3rd Street, Stockton, MO 65785-9608 | 2012-03-14 |
| 1184851578 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 4774 West Lane, Stockton, CA 95210-0000 | 2009-06-12 |
| 1023271822 | Active Life Medical Products Inc | Durable Medical Equipment & Medical Supplies | 4217 Coronado Ave, Suite D, Stockton, CA 95204-2335 | 2008-07-02 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.