Organization Active NPI

Choice Medical Supply Inc

  • Durable Medical Equipment & Medical Supplies
  • Abilene, TX
National Provider Identifier
1114925856
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0036515 Issued in TX
Legal business name
CHOICE MEDICAL SUPPLY INC
Practice address
17 Windmill Cir
Abilene, TX 79606-5234
Phone
(325) 677-2250
Fax
(325) 677-2124
NPI assigned
Jul 7, 2005
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
J'Lynn Adams
Title
Office Manager
Phone
(325) 677-2250

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0012861 TX
Durable Medical Equipment & Medical Supplies 332B00000X 0036515 TX Primary

Addresses

Primary practice location

17 Windmill Cir
Abilene, TX 79606-5234

Mailing address

17 Windmill Cir
Abilene, TX 79606-5234
Phone (325) 677-2250

Other identifiers 1

IdentifierTypeStateIssuer
519707OtherTXBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930027868 TX DME Supplier - Medical Supply CompanyDME Supplier - Orthotic PersonnelDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 6800916842 Practice locations: Abilene, TX

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Choice Medical Supply Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

17 Windmill Cir
Abilene, TX 79606
Phone (325) 677-2250

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1114925856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WINDMILL CIR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065234",
            "telephone_number": "325-677-2250",
            "fax_number": "325-677-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WINDMILL CIR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065234",
            "telephone_number": "325-677-2250",
            "fax_number": "325-677-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "J'LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "325-677-2250"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0012861",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0036515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "519707",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.