Med South Home Medical Services, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

MED SOUTH HOME MEDICAL SERVICES, LLC

Practice address

205 E. Lee Street
Enterprise, AL 36330-2626

Phone

(334) 308-1355

Fax

(334) 308-1358

NPI assigned

Jun 28, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Lisa J. Wells, CPCO

Title

Executive Director

Phone

(205) 221-8258

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Med-South, Inc.

  • Pharmacy
  • Pelham, AL
  • NPI 1891771515

  Member Of

  NPD member

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1316468515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 MEDICAL CENTER DR.",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355013400",
            "telephone_number": "205-221-8200",
            "fax_number": "205-221-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E. LEE STREET",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302626",
            "telephone_number": "334-308-1355",
            "fax_number": "334-308-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED SOUTH HOME MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-28",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-221-8258",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPCO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219493",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McDonough OBGYN
• Kaitlyn Ireland McKenzie
• Pamela Dawson McKowen, LPC
• Hannah Elizabeth McQueen, N.P.
• James Michael McQueen, M.D.
• Med-Home Inc.
• Medical and Surgical Eyecare of Enterprise
• Medsouth Inc
• Meghani Medical, PC
• Angel Melton, M.S. ,LPC

• Oxygen Equipment & Supplies (DME) in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Oxygen Equipment & Supplies (DME) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.