St Jude Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ST JUDE MEDICAL SUPPLY

Practice address

3900 Merton Dr Ste 130
Raleigh, NC 27609-6636

Phone

(984) 242-4742

NPI assigned

Jun 25, 2021

Last updated

Jan 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jude Nwaodu

Title

President

Phone

(919) 618-8033

Specialties & licenses 3

Addresses

Other names 1

• st. jude medical supply Former legal business name

Locations

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1376113068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 MERTON DR STE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096636",
            "telephone_number": "984-242-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 MERTON DR STE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096636",
            "telephone_number": "984-242-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JUDE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "NWAODU",
        "authorized_official_first_name": "JUDE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-618-8033",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "st. jude medical supply",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Megan Marie Sredl, MSN, FNP-BC
• Sachin Sreenivasan, MD
• Abhishek Sripad, MD
• Samuel K St Clair, MD
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• Natasha St. Fort
• Kyle M St. Jean, CRNA
• Tanya St. Julien, LPC
• Katie Lyn St. Pierre, PMHNP-BC, FNP-BC
• St' Ephraims Home Healthcare Services LLC

• Durable Medical Equipment & Medical Supplies in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.