The Medical Store Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

THE MEDICAL STORE INC

Practice address

1201 College Ave Ste B
Jackson, AL 36545-2406

Phone

(251) 246-0444

Fax

(251) 246-7754

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Robbin A McKee

Title

Owner/Ceo

Phone

(251) 769-6414

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1043230816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 COLLEGE AVE STE B",
            "city": "JACKSON",
            "state": "AL",
            "postal_code": "365452406",
            "telephone_number": "251-246-0444",
            "fax_number": "251-246-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 COLLEGE AVE STE B",
            "city": "JACKSON",
            "state": "AL",
            "postal_code": "365452406",
            "telephone_number": "251-246-0444",
            "fax_number": "251-246-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "MCKEE",
        "authorized_official_first_name": "ROBBIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "251-769-6414"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000056488",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "51056488",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0040362",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Jackson, AL
• Providers in Jackson, AL by specialty
• Durable Medical Equipment & Medical Supplies in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.