HAVASU MEDICAL SUPPLY INC.
NPI 1205891124
Durable Medical Equipment & Medical Supplies in Lake Havasu City, AZ

Active since April 20, 2006
1849 ACOMA BLVD W STE 116, LAKE HAVASU CITY, AZ 86403(928) 854-1868(928) 854-1865 Get Directions Write a Review

NPPES record last updated: October 10, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Havasu Medical Supply Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HAVASU MEDICAL SUPPLY INC. (NPI 1205891124) is a healthcare organization registered as a durable medical equipment & medical supplies in Lake Havasu City, Arizona and active in the NPI registry since April 2006. The organization lists Jim Jay Goldman, Owner Rt, as its authorized official.

NPPES Registry Identity

NPI1205891124
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameHAVASU MEDICAL SUPPLY INC.
Location Address1849 ACOMA BLVD W STE 116Lake Havasu City, AZ 86403-3184
Mailing Address1849 Acoma Blvd W Ste 116Lake Havasu City, AZ 86403-3184 · (928) 854-1868 · Fax (928) 854-1865
Fax(928) 854-1865
Organization SubpartNo
Authorized OfficialJim Jay GoldmanOwner Rt · (928) 854-1868
Enumeration DateApril 20, 2006
Last NPPES UpdateOctober 10, 2008
NPI 1205891124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
License Licensed in AZ · 332B00000X
Definition

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.

1849 ACOMA BLVD W STE 116, Lake Havasu City, AZ 86403

Other Identifiers 1

Medicare ID-Type Unspecified4692470001AZ · Provider Id

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Havasu Medical Supply Inc.'s NPI number?

The NPI number for Havasu Medical Supply Inc. is 1205891124. It was assigned to this organization in the NPPES registry on April 20, 2006.

Where is Havasu Medical Supply Inc. located?

Havasu Medical Supply Inc. is located at 1849 Acoma Blvd W Ste 116, Lake Havasu City, AZ 86403. The listed phone number is (928) 854-1868.

What is Havasu Medical Supply Inc.'s specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Havasu Medical Supply Inc. was last updated on October 10, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.