Supermed Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

HME868 Issued in FL

Legal business name

SUPERMED INC

Practice address

525 Shadow Lakes Blvd
Ormond Beach, FL 32174-5003

Phone

(386) 672-9530

Fax

(386) 677-2072

NPI assigned

Aug 10, 2005

Last updated

Feb 12, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Phillip Bane

Title

President

Phone

(540) 397-4318

Specialties & licenses 2

Addresses

Other identifiers 4

Tax ID family

Medpend2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Supermed, Inc

  dba medpend

  • Durable Medical Equipment & Medical Supplies
  • Ormond Beach, FL
  • NPI 1316071277
  NPD tax ID

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392163200000",
    "number": "1083616098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 SHADOW LAKES BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745003",
            "telephone_number": "386-672-9530",
            "fax_number": "386-677-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 SHADOW LAKES BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745003",
            "telephone_number": "386-672-9530",
            "fax_number": "386-677-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERMED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2014-02-12",
        "status": "A",
        "authorized_official_last_name": "BANE",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-397-4318"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "HME868",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "FL",
            "license": "HME868",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025440100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDWAIVER",
            "identifier": "683944498",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDWAIVER (COA)",
            "identifier": "683661500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDWAIVER (DCF)",
            "identifier": "683944496",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Sullivan
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• Adrianna Sung, DO
• Sunrise Community, Inc.
• Supermed, Inc (medpend)
• Suresh Desai MD PA
• Dianna Lynn Sutton, LCSW
• James Thomas Sutton, M.D.
• Jesse Sweatt Jr., PTA

• Durable Medical Equipment & Medical Supplies in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.