The Medical Store, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

050-05340-4 Issued in MS

Legal business name

THE MEDICAL STORE, INC.

Practice address

1911 14TH St
Meridian, MS 39301-4145

Phone

(601) 482-0099

NPI assigned

Sep 22, 2006

Organization subpart

Yes

Parent organization

RUSH HEALTH SYSTEMS, INCAs reported in NPPES

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

Authorized official

Name

Mr. Don Larkin Kennedy

Title

President

Phone

(601) 703-9614

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Ochsner Pharmacy and Wellness, LLC

  • Clinic Pharmacy
  • New Orleans, LA
  • NPI 1518073824

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650499200000",
    "number": "1124127220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5502",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025502",
            "telephone_number": "601-482-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014145",
            "telephone_number": "601-482-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL STORE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUSH HEALTH SYSTEMS, INC",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "LARKIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-703-9614",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "050-05340-4",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040221",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "000011075",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008805990",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• The Counselor'S Cabin PLLC
• The Free Clinic of Meridian, Inc.
• The Pharmacy of Meridian
• Jasmine Thedford
• Shana Thedford, RO
• Theta Home Health Care Inc
• Anthony L Thomas, M.D.

• Durable Medical Equipment & Medical Supplies in Meridian, MS
• Providers in Meridian, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.