NPIMap

Organization Active NPI

Family Medical Supply LLC

  • Oxygen Equipment & Supplies (DME)
  • Clinton, NC
National Provider Identifier
1124123070
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
00904 Issued in NC
Legal business name
FAMILY MEDICAL SUPPLY LLC
Practice address
329 North Blvd
Clinton, NC 28328-1911
Phone
(910) 592-0449
Fax
(910) 592-0529
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Stephen Griggs
Title
Ceo
Phone
(407) 206-0040

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X 00904 NC Primary

Addresses

Primary practice location

329 North Blvd
Clinton, NC 28328-1911

Mailing address

220 W Germantown Pike Ste 250
Plymouth Meeting, PA 19462-1437

Other identifiers 1

IdentifierTypeStateIssuer
0490TOtherNCBCBS PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930047446 NC DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 2062539620 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shallotte, NC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Supply LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1124123070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W GERMANTOWN PIKE STE 250",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 NORTH BLVD",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283281911",
            "telephone_number": "910-592-0449",
            "fax_number": "910-592-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "GRIGGS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-206-0040"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NC",
            "license": "00904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "0490T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.