PROVIDENCE MEDICAL SUPPLY LLC
NPI 1659096410
Durable Medical Equipment & Medical Supplies in Ontario, CA

Q: What is Providence Medical Supply LLC's NPI number?

The NPI number for Providence Medical Supply LLC is 1659096410. It was assigned to this organization in the NPPES registry on October 4, 2022.

Q: What is Providence Medical Supply LLC's specialty?

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

Active since October 04, 2022

1125 N MOUNTAIN AVE, ONTARIO, CA 91762(909) 443-7115 Get Directions Write a Review

NPPES record last updated: December 25, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 25, 2022, Oct 4, 2022 (2 updates tracked since 2022).

On this page

About Providence Medical Supply Llc NPPES

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

PROVIDENCE MEDICAL SUPPLY LLC (NPI 1659096410) is a healthcare organization registered as a durable medical equipment & medical supplies in Ontario, California and active in the NPI registry since October 2022. The organization lists Yusif J Salia, Managing Director, as its authorized official.

NPPES Registry Identity

NPI1659096410

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NamePROVIDENCE MEDICAL SUPPLY LLC

Location Address1125 N MOUNTAIN AVEOntario, CA 91762-1739

Mailing Address1125 N Mountain AveOntario, CA 91762-1739 · (909) 443-7115

Phone(909) 443-7115

Organization SubpartNo

Authorized OfficialYusif J SaliaManaging Director · (213) 379-1424

Enumeration DateOctober 4, 2022

Last NPPES UpdateDecember 25, 20222 updates tracked since enumeration

NPPES CertifiedDecember 25, 2022

✔ NPI 1659096410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

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.

1125 N MOUNTAIN AVE, Ontario, CA 91762

Open in Google Maps ↗

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories Providence Medical Supply LLC carries, from the Medicare DMEPOS supplier directory.

Providence Medical Supply LLC

DMEPOS supplier · Ontario, CA

⋮

Does not accept Medicare assignment

Providence Medical Supply LLC has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20307629

Medicare Participant SinceJanuary 19, 2023

Supplier Location1125 N Mountain AveOntario, CA 91762

Phone(909) 443-7115

Supplier Specialties

Medical Supply Company Other

Medicare Product Categories

Commodes, Urinals, Bedpans

Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Blood Glucose Monitors/Supplies (Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Heat & Cold Applications

Heat therapy, Cold therapy, Heating pads

Hospital Beds (Electric)

Total electric hospital beds, Semi-electric hospital beds

Hospital Beds (Manual)

Fixed height hospital beds, Variable height hospital beds

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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 Providence Medical Supply LLC's NPI number?

The NPI number for Providence Medical Supply LLC is 1659096410. It was assigned to this organization in the NPPES registry on October 4, 2022.

Where is Providence Medical Supply LLC located?

Providence Medical Supply LLC is located at 1125 N Mountain Ave, Ontario, CA 91762. The listed phone number is (909) 443-7115.

What is Providence Medical Supply LLC's specialty?

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

Does Providence Medical Supply LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Providence Medical Supply LLC does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

When was this NPI record last updated?

The NPPES record for Providence Medical Supply LLC was last updated on December 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.