Organization Active NPI

Tamarack LTD

  • Durable Medical Equipment & Medical Supplies
  • Beckley, WV
National Provider Identifier
1003872904
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
TAMARACK LTD
Practice address
386 Ragland Rd
Beckley, WV 25801-9722
Phone
(304) 255-6500
Fax
(304) 253-5420
NPI assigned
Apr 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. John H Johnson Jr.
Title
Ceo
Phone
(304) 255-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

386 Ragland Rd
Beckley, WV 25801-9722

Mailing address

PO Box 1102
Beckley, WV 25802-1102
Phone (304) 255-6500

Other identifiers 1

IdentifierTypeStateIssuer
0148499000MedicaidWV

National Provider Directory

National Provider Directory

Locations

386 Ragland Rd
Beckley, WV 25801
Phone (304) 255-6500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346976000000",
    "number": "1003872904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1102",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258021102",
            "telephone_number": "304-255-6500",
            "fax_number": "304-253-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 RAGLAND RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258019722",
            "telephone_number": "304-255-6500",
            "fax_number": "304-253-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMARACK LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2012-09-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-255-6500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148499000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; 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.