NPIMap

Organization Active NPI

Southern Illinois Surgical Appliance Co

  • Durable Medical Equipment & Medical Supplies
  • West Frankfort, IL
National Provider Identifier
1104807056
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
2032 1120 Issued in IL
Legal business name
SOUTHERN ILLINOIS SURGICAL APPLIANCE CO
Practice address
19 W Frankfort PLZ
West Frankfort, IL 62896-4964
Phone
(618) 932-3157
Fax
(618) 932-3031
NPI assigned
Nov 8, 2005
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Ralph Randolph Lewis
Title
President
Phone
(618) 932-3157

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 2032 1120 IL Primary
Oxygen Equipment & Supplies (DME) 332BX2000X 2032-1120 IL

Addresses

Primary practice location

19 W Frankfort PLZ
West Frankfort, IL 62896-4964

Mailing address

19 W Frankfort PLZ
West Frankfort, IL 62896-4964
Phone (618) 932-3157

Other names 1

  • SISA Home Medical Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1104807056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 W FRANKFORT PLZ",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628964964",
            "telephone_number": "618-932-3157",
            "fax_number": "618-932-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W FRANKFORT PLZ",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628964964",
            "telephone_number": "618-932-3157",
            "fax_number": "618-932-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS SURGICAL APPLIANCE CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-932-3157",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "2032 1120",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IL",
            "license": "2032-1120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SISA Home Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.