Old Town Medical Equipment LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OLD TOWN MEDICAL EQUIPMENT LLC

Practice address

100 Chapel Dr Ste E
Monett, MO 65708-9378

Phone

(417) 635-1100

Fax

(800) 805-6180

NPI assigned

Jun 21, 2016

Last updated

Jun 21, 2016By 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

Mr. Shane Michael Becker, PHARM D RPHNPI 1386767788

Title

Owner/Pharmacist/Pic

Phone

(417) 635-1100

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shane Micheal Becker, PHARM. D., RPH

  • Pharmacist
  • Monett, MO
  • NPI 1386767788
  Authorized official Same address or phone

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1114377074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CHAPEL DR STE E",
            "city": "MONETT",
            "state": "MO",
            "postal_code": "657089378",
            "telephone_number": "417-635-1100",
            "fax_number": "800-805-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHAPEL DR STE E",
            "city": "MONETT",
            "state": "MO",
            "postal_code": "657089378",
            "telephone_number": "417-635-1100",
            "fax_number": "800-805-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN MEDICAL EQUIPMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PHARMACIST/PIC",
        "authorized_official_telephone_number": "417-635-1100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM D RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Francis Netzer, DC
• Sherri Jo Newell-Sorrell, OTR/L
• Aubrey A Nixon, LMT
• Linley O'Hara, RN
• Jason Erwin Obermann, DO
• Old Town Pharmacy LLC
• Old Town Pharmacy LLC (Old Town Pharmacy)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Paabs LLC (Old Town PAABS)
• Jolene Palmquist, OTR

• Durable Medical Equipment & Medical Supplies in Monett, MO
• Providers in Monett, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.