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

Q: 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.

Q: 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.

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: August 16, 2026.

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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

Phone(928) 854-1868

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

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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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.