NPIMap

Organization Active NPI

Medcentrix Inc

  • Home Infusion Therapy Pharmacy
  • Chicago, IL
National Provider Identifier
1275101164
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
Legal business name
MEDCENTRIX INC
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(773) 834-5601
Fax
(773) 702-6631
NPI assigned
Jun 16, 2021
Last updated
Jun 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Authorized official

Name
Randy Neiswonger
Title
Interim President
Phone
(708) 915-6111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Home Infusion Therapy Pharmacy 3336H0001X Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 834-5601

National Provider Directory

National Provider Directory
Tax ID family
Medcentrix Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1275101164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-834-5601",
            "fax_number": "773-702-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-834-5601",
            "fax_number": "773-702-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCENTRIX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "NEISWONGER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "INTERIM PRESIDENT",
        "authorized_official_telephone_number": "708-915-6111"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.