Bencor Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BENCOR MEDICAL LLC

Doing business as

Southeastern Neb Pros

Practice address

4210 Columbia Rd
BLDG 6
Martinez, GA 30907-0401

Phone

(800) 620-6327

Fax

(706) 869-7229

NPI assigned

Dec 22, 2005

Last updated

May 21, 2010By 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. John R Huss

Title

President

Phone

(770) 601-9199

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Southeastern Neb Pros Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274400000000",
    "number": "1285611012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 COLUMBIA RD",
            "address_2": "BLDG 6",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070401",
            "telephone_number": "800-620-6327",
            "fax_number": "706-869-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 COLUMBIA RD",
            "address_2": "BLDG 6",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070401",
            "telephone_number": "800-620-6327",
            "fax_number": "706-869-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENCOR MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2010-05-21",
        "status": "A",
        "authorized_official_last_name": "HUSS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-601-9199",
        "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": "DE2533",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040918183A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Neb Pros",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Martinez, GA
• Providers in Martinez, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.