E & S Medical Supply Co

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0007209908 Issued in IN

Legal business name

E & S MEDICAL SUPPLY CO

Practice address

500 Broadway Ste B
Chesterton, IN 46304-2393

Phone

(219) 395-1026

Fax

(219) 395-1625

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Deforest Wayne Shobe

Title

President

Phone

(219) 395-1026

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1376642116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BROADWAY",
            "address_2": "STE B",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042393",
            "telephone_number": "219-395-1026",
            "fax_number": "219-395-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BROADWAY STE B",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042393",
            "telephone_number": "219-395-1026",
            "fax_number": "219-395-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E & S MEDICAL SUPPLY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "SHOBE",
        "authorized_official_first_name": "DEFOREST",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-395-1026",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "0007209908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200211710A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.