Emerald Coast Medical Supplies LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

EMERALD COAST MEDICAL SUPPLIES LLC

Practice address

48 Bald Eagle Dr
Santa Rosa Beach, FL 32459

Phone

(850) 420-2240

NPI assigned

Apr 2, 2017

Organization subpart

No

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

Authorized official

Name

Tara Foster

Title

Owner

Phone

(850) 420-2240

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1491091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1023540648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 BALD EAGLE DR",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324598342",
            "telephone_number": "850-420-2240",
            "fax_number": "850-344-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 BALD EAGLE DR",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "32459",
            "telephone_number": "850-420-2240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7720 US Highway 98 W",
            "address_2": "suite 260",
            "address_purpose": "LOCATION",
            "city": "Miramar Beach",
            "state": "FL",
            "postal_code": "325507230",
            "country_code": "US",
            "telephone_number": "850-687-7335",
            "fax_number": "850-344-9758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMERALD COAST MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-02",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-420-2240"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "7EHGC",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.