Organization Active NPI

Crossroads Medical Supply,Inc.

  • Durable Medical Equipment & Medical Supplies
  • New Lenox, IL
National Provider Identifier
1154656916
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CROSSROADS MEDICAL SUPPLY,INC.
Practice address
205 W Joliet Hwy
205 W. Joliet Hwy.
New Lenox, IL 60451-2111
Phone
(815) 791-6644
NPI assigned
Oct 13, 2009
Last updated
Oct 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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

Authorized official

Name
Patrick J Flynn
Title
Vice President
Phone
(815) 791-6644

Specialties & licenses 1

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

Addresses

Primary practice location

205 W Joliet Hwy
205 W. Joliet Hwy.
New Lenox, IL 60451-2111

Mailing address

PO Box 275
205 W. Joliet Hwy.
New Lenox, IL 60451-0275
Phone (815) 791-6644

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1154656916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 275",
            "address_2": "205 W. JOLIET HWY.",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604510275",
            "telephone_number": "815-791-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W JOLIET HWY",
            "address_2": "205 W. JOLIET HWY.",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604512111",
            "telephone_number": "815-791-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS MEDICAL SUPPLY,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-13",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "815-791-6644"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; 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.