Clover Family Corp | NPI 1306825005

Key facts

NPI: 1306825005
Entity type: Organization (NPI type 2)
Primary specialty: Durable Medical Equipment & Medical Supplies 332B00000X
License: 00131 (NC)
Legal business name: CLOVER FAMILY CORP
Practice address: 1040 S Church St
Burlington, NC 27215-5046
Phone: (336) 222-8052
Fax: (336) 222-8091
NPI assigned: Jan 11, 2006
Organization subpart: No

Authorized official

Name: Jason Alexander NPI 1437932332
Title: President
Phone: (919) 812-4557

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Jason Alexander Orthotic Fitter · Burlington, NC · NPI 1437932332

NPD (past) Authorized official
Clover Marjorie Colonel, R.N. Prosthetic/Orthotic Supplier · Burlington, NC · NPI 1831346964

NPD (past) PROSTHETIC/ORTHOTIC SUPPLIER
Thomas Martin Colonel, RPH Pharmacist · Burlington, NC · NPI 1013063874

NPD (past)

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

Supplier	Supplies	Medicare assignment
Clover Family Corp 1040 S Church St, Burlington, NC 27215-5046 · (336) 222-8052	Commodes, Urinals, Bedpans\|Heat & Cold Applications\|Hospital Beds (Electric)\|Hospital Beds (Manual)\|Pneumatic Compression Devices and/or Supplies\|Support Surfaces: Pressure Reducing Beds/Mats/Pads\|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies\|Canes and/or Crutches\|Patient Lifts…	Does not accept assignment Participating since Jan 20, 2004

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NC

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20100930031575	NC	DME Supplier - Medical Supply Company DME Supplier - Medical Supply Company With Orthotic-Prosthetic	7719194802	Practice locations: Burlington, NC

National Provider Directory

Locations

1040 S Church St
Burlington, NC 27215
Phone (336) 222-8052

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	00131	NC	Yes
Prosthetic/Orthotic Supplier	335E00000X

Addresses

Primary practice location

1040 S Church St
Burlington, NC 27215-5046

Mailing address

1040 S Church St
Burlington, NC 27215-5046
Phone (336) 222-8052

Other identifiers

Identifier	Type	State	Issuer
30205	Other	NC	CHILD PHONE NUMBER

Other names

CLOVER'S MASTECTOMY AND MEDICAL SUPPLY Doing business as

Other providers in Burlington, NC

All providers in Burlington, NC · Durable Medical Equipment & Medical Supplies in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.