Edge Medical Supply, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

EDGE MEDICAL SUPPLY, LLC

Practice address

411 E Rusk St
Jacksonville, TX 75766

Phone

(903) 541-0220

Fax

(903) 541-0440

NPI assigned

Sep 25, 2006

Last updated

Jul 25, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

AEROCARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Mr. Stephen P. Griggs

Title

Ceo

Phone

(407) 206-0040

Specialties & licenses 3

Addresses

Other identifiers 2

Part of

Aerocare Holdings Inc

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Adapthealth West, LLC

  dba AdaptHealth

  • Durable Medical Equipment & Medical Supplies
  • Lone Tree, CO
  • NPI 1366036626

  Member Of

  NPD member
• Aerocare Holdings, Inc

  dba AeroCare

  • Oxygen Equipment & Supplies (DME)
  • Pueblo, CO
  • NPI 1588603526

  Member Of

  NPD member

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1073613147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 BARTLETT BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328116428",
            "telephone_number": "407-206-0040",
            "fax_number": "407-206-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E RUSK ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "75766",
            "telephone_number": "903-541-0220",
            "fax_number": "903-541-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE MEDICAL SUPPLY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AEROCARE HOLDINGS, INC.",
        "enumeration_date": "2006-09-25",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "GRIGGS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-206-0040",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158127403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158217413",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Texas Eye Care Associates PLLC (The Optical Shop)
• East Texas Medical Center Healthcare Associates (First Physicians)
• East Texas Medical Center Jacksonville
• East Texas Medical Center Jacksonville (ETMC First Physicians Clinic Jacksonville)
• Ruth S Eckenrod, PTA
• Eirah Elmer, LPC-S
• Kenya Sekoni Etim, M.D.
• Etmc Physician Group Inc. (UT Health East Texas Physicians)
• Eric Paul Evans
• Evercareplus Inc (EverCarePlus Pharmacy)

• Oxygen Equipment & Supplies (DME) in Jacksonville, TX
• Providers in Jacksonville, TX by specialty
• Oxygen Equipment & Supplies (DME) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.