NPIMap

Organization Active NPI

Nickes Medical Supply, LLC.

  • Durable Medical Equipment & Medical Supplies
  • Savannah, GA
National Provider Identifier
1154983880
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NICKES MEDICAL SUPPLY, LLC.
Practice address
6020 Halsey St
Savannah, GA 31405
Phone
(915) 533-8870
Fax
(915) 533-0078
NPI assigned
Jul 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Authorized official

Name
Ngozi Kathleen Austin-Eleje
Title
Owner/ Manager
Phone
(915) 533-8870

Specialties & licenses 1

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

Addresses

Primary practice location

6020 Halsey St
Savannah, GA 31405

Mailing address

2820 N Stanton St
El Paso, TX 79902-2509
Phone (915) 533-8870

National Provider Directory

National Provider Directory
Tax ID family
Nickes Medical Supply LLC4 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.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1154983880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N STANTON ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799022509",
            "telephone_number": "915-533-8870",
            "fax_number": "915-533-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 HALSEY ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "915-533-8870",
            "fax_number": "915-533-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICKES MEDICAL SUPPLY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "AUSTIN-ELEJE",
        "authorized_official_first_name": "NGOZI",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER/ MANAGER",
        "authorized_official_telephone_number": "915-533-8870"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.