Phoenix Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PHOENIX MEDICAL SUPPLY LLC

Practice address

29 S New York Rd Ste 900
Galloway, NJ 08205-9697

Phone

(215) 453-8367

NPI assigned

Mar 8, 2019

Organization subpart

No

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

Authorized official

Name

Dana Denner

Title

President

Phone

(609) 617-8387

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1073071072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 S NEW YORK RD STE 900",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059697",
            "telephone_number": "215-453-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S NEW YORK RD STE 900",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059697",
            "telephone_number": "215-453-8367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4007 McCullough Ave Ste 438",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782122420",
            "country_code": "US",
            "telephone_number": "888-712-0146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHOENIX MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-08",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "DENNER",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-617-8387"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Joseph Petruzzi, M.D.
• Kimberly K Pettit, RBT
• Pharmacy Operations Inc (Medicap Pharmacy)
• Sherry Lynn Pharo
• Philip Paparone DO PA
• Steven Pinard, O.D.
• Ayrrin Pincus, LSW
• Jaime Lynne Pitcher, MA, LAC
• Jamie Lea Plata, FNP-C
• Positive Therapy Solutions, LLC

• Durable Medical Equipment & Medical Supplies in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.