Independent Medical Supplies Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

INDEPENDENT MEDICAL SUPPLIES INC

Practice address

633 N Brown St
Chadbourn, NC 28431-1305

Phone

(910) 654-4876

Fax

(910) 654-6876

NPI assigned

Jan 30, 2007

Last updated

Aug 22, 2020By 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

Mr. Sherwood Shane Enzor

Title

President Manager

Phone

(910) 654-4876

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235276452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 353",
            "city": "CHADBOURN",
            "state": "NC",
            "postal_code": "284310353",
            "telephone_number": "910-654-4876",
            "fax_number": "910-654-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 N BROWN ST",
            "city": "CHADBOURN",
            "state": "NC",
            "postal_code": "284311305",
            "telephone_number": "910-654-4876",
            "fax_number": "910-654-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT MEDICAL SUPPLIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENZOR",
        "authorized_official_first_name": "SHERWOOD",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT   MANAGER",
        "authorized_official_telephone_number": "910-654-4876",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704006",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Chadbourn, NC
• Providers in Chadbourn, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.