Personal Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

203-000093 Issued in IL

Legal business name

PERSONAL MEDICAL SUPPLY, INC.

Practice address

373 W 1St Dr
Decatur, IL 62521-5207

Phone

(217) 422-1271

Fax

(217) 422-7066

NPI assigned

Sep 20, 2005

Last updated

Oct 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sharon A MC Chancy

Title

Owner

Phone

(217) 422-1271

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1225023898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 W 1ST DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625215207",
            "telephone_number": "217-422-1271",
            "fax_number": "217-422-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 W 1ST DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625215207",
            "telephone_number": "217-422-1271",
            "fax_number": "217-422-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "MC CHANCY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-422-1271"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203-000093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian David Penwell, D.C.
• Nancy L Penwell, D.C.
• Amber Perkinson
• Kailey N Perry, COTA/L
• Laura Perry, L.M.T
• Leeann Petak, CRNA
• Tonya Sue Peters, SLP
• Jon Fredrick Petersen, M.D.
• Julia Peterson
• Waymond Jay Pettit, M.D.

• Durable Medical Equipment & Medical Supplies in Decatur, IL
• Providers in Decatur, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.