Carroll Apothecary, Inc

Organization Active NPI Durable Medical Equipment & Medical Supplies · Jefferson, IA

NPI 1366435364 · NPPES record last updated Mar 28, 2008

Key facts

NPI
1366435364
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
CARROLL APOTHECARY, INC
Practice address
118 N Wilson Ave
Jefferson, IA 50129-2116
Phone
(515) 386-4628
Fax
(515) 386-2247
NPI assigned
Aug 24, 2005
Organization subpart
Yes
Parent organization (as reported)
PHARMACY ASSOCIATES OF CARROLL, INC

Authorized official

Name
Rhonda Hoffman
Title
Manager
Phone
(712) 792-6184

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

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

SupplierSuppliesMedicare assignment
Home Care Medical Equipment
118 N Wilson Ave, Jefferson, IA 50129-2116 · (515) 386-4628
Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Canes and/or Crutches|Seat Lift Mechanisms|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manua… Does not accept assignment
Participating since Nov 23, 2009

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930088285 IA DME Supplier - Medical Supply Company With Respiratory Therapist
DME Supplier - Medical Supply Company
DME Supplier - Oxygen & Equipment
DME Supplier - Prosthetic Personnel
DME Supplier - Orthotic Personnel
DME Supplier - Medical Supply Company With Prosthetic Personnel
DME Supplier - Medical Supply Company With Orthotic Personnel
5597844902 Practice locations: Jefferson, IA

National Provider Directory

Tax ID family
Carroll Apothecary Inc (5 organizations share this tax ID)
Part of
Pharmacy Assoc Carroll Inc

Locations

118 N Wilson Ave
Jefferson, IA 50129
Phone (515) 386-4628

Specialties & licenses

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

Addresses

Primary practice location

118 N Wilson Ave
Jefferson, IA 50129-2116

Mailing address

118 N Wilson Ave
Jefferson, IA 50129-2116
Phone (515) 386-4628

Other identifiers

IdentifierTypeStateIssuer
0230292MedicaidIA

Other names

  • Home Care Medical Equipment Doing business as

Other providers in Jefferson, IA

All providers in Jefferson, IA · Durable Medical Equipment & Medical Supplies in Iowa

Sources for this page

Verify at the official NPI Registry.