Crestview Medical Equipment Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CRESTVIEW MEDICAL EQUIPMENT SUPPLY LLC

Practice address

2100 S Great Southwest Pkwy
Ste 103
Grand Prairie, TX 75051-3543

Phone

(972) 853-7422

NPI assigned

Oct 17, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Olumuyiwa Akinyode

Title

President/Ceo

Phone

(972) 853-7422

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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": "1224201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1366694622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S GREAT SOUTHWEST PKWY",
            "address_2": "STE 103",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750513543",
            "telephone_number": "972-853-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S GREAT SOUTHWEST PKWY",
            "address_2": "STE 103",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750513543",
            "telephone_number": "972-853-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW MEDICAL EQUIPMENT SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-17",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "AKINYODE",
        "authorized_official_first_name": "OLUMUYIWA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "972-853-7422",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211490201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211490202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.