Active NPI
Cumberland Medical Supply
- Parenteral & Enteral Nutrition Supplies (DME)
- Springfield, OH
National Provider Identifier
1366488199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Parenteral & Enteral Nutrition Supplies (DME)
- Legal business name
- CUMBERLAND MEDICAL SUPPLY
- Practice address
- 4105 S Charleston Pike
Springfield, OH 45502-9375 - Phone
- (937) 629-0962
- Fax
- (937) 629-0980
- NPI assigned
- Jun 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. W. Blaine Sheffield
- Title
- President
- Phone
- (850) 654-8939
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | Primary |
Addresses
Primary practice location
4105 S Charleston Pike
Springfield, OH 45502-9375
Mailing address
4383 Stonebridge Rd
Destin, FL 32541-3463
Phone (850) 654-8939
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1455128 | Medicaid | TN | |
| 3810008256 | Medicaid | WV | |
| R02256159 | Medicaid | KY | |
| 101884075 | Medicaid | PA | |
| 2052513 | Medicaid | OH | |
| 100031700 | Medicaid | IN |
National Provider Directory
National Provider DirectoryLocations
4105 S Charleston Pike
Ste A
Springfield, OH 45502
Phone (937) 629-0962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1252972800000",
"number": "1366488199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4383 STONEBRIDGE RD",
"city": "DESTIN",
"state": "FL",
"postal_code": "325413463",
"telephone_number": "850-654-8939",
"fax_number": "850-654-8939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4105 S CHARLESTON PIKE",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455029375",
"telephone_number": "937-629-0962",
"fax_number": "937-629-0980"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CUMBERLAND MEDICAL SUPPLY",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-21",
"last_updated": "2009-09-15",
"status": "A",
"authorized_official_last_name": "SHEFFIELD",
"authorized_official_first_name": "W.",
"authorized_official_middle_name": "BLAINE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "850-654-8939",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1455128",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810008256",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "R02256159",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101884075",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2052513",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100031700",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.