William McCoy

Individual provider Active NPI Durable Medical Equipment & Medical Supplies · Jackson, MO

NPI 1083078786 · NPPES record last updated Apr 8, 2016

Key facts

NPI
1083078786
Entity type
Individual (NPI type 1)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Practice address
415 W Main St
Suite B
Jackson, MO 63755-1801
Phone
(573) 290-2841
Fax
(573) 290-2881
NPI assigned
Apr 8, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Ae Wellness, LLC Durable Medical Equipment & Medical Supplies Past Accepting new patients

Specialties & licenses

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

Addresses

Primary practice location

415 W Main St
Suite B
Jackson, MO 63755-1801

Mailing address

415 W Main St
Suite B
Jackson, MO 63755-1801
Phone (573) 290-2841

Other providers in Jackson, MO

All providers in Jackson, MO · Durable Medical Equipment & Medical Supplies in Missouri

Sources for this page

Verify at the official NPI Registry.