NPIMap

Organization Active NPI

Lifestore Medical Supply, LLC

  • Durable Medical Equipment & Medical Supplies
  • Boca Raton, FL
National Provider Identifier
1245532191
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LIFESTORE MEDICAL SUPPLY, LLC
Practice address
5255 N Federal Hwy
Boca Raton, FL 33487-4901
Phone
(561) 953-1200
Fax
(561) 241-6160
NPI assigned
Nov 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Authorized official

Name
Mr. Bruce Godwin
Title
MMBR
Phone
(561) 953-1200

Specialties & licenses 1

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

Addresses

Primary practice location

5255 N Federal Hwy
Boca Raton, FL 33487-4901

Mailing address

5255 N Federal Hwy
Boca Raton, FL 33487-4901
Phone (561) 953-1200

National Provider Directory

National Provider Directory

Locations

5255 N Federal Hwy
Boca Raton, FL 33487
Phone (561) 953-1200

NPI Registry JSON

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1245532191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334874901",
            "telephone_number": "561-953-1200",
            "fax_number": "561-241-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334874901",
            "telephone_number": "561-953-1200",
            "fax_number": "561-241-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTORE MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "MMBR",
        "authorized_official_telephone_number": "561-953-1200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.