Fifty 50 Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

26217 Issued in TX

Legal business name

FIFTY 50 MEDICAL LLC

Practice address

1411 E Sandy Lake Rd Ste 120
Coppell, TX 75019-7947

Phone

(972) 243-2727

Fax

(972) 243-3111

NPI assigned

Nov 12, 2008

Organization subpart

No

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

Authorized official

Name

Maxine Wilson

Title

GM

Phone

(972) 243-2727

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 1

• Fifty50 Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1376797704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E SANDY LAKE RD STE 120",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750197947",
            "telephone_number": "972-243-2727",
            "fax_number": "972-243-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E SANDY LAKE RD STE 120",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750197947",
            "telephone_number": "972-243-2727",
            "fax_number": "972-243-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFTY 50 MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MAXINE",
        "authorized_official_title_or_position": "GM",
        "authorized_official_telephone_number": "972-243-2727"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "26217",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100792330A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201737803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201737801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121078",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143875716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fifty50 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fifty50 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dillon Fedak, DPT
• Micheala Marie Ferguson, NP-C
• Karen Denise Ferrell
• Grace Marie Fesler, M.S., CCC-SLP
• Cristina Fetter, M.S. CCC/SLP
• Teresa Finazzo, RDN, LD
• Heather Finley, RD, LD, CLT
• Courtney Christine Fitzsimons, OTR/L
• Fleming&Associates LLC
• Georgina Flores, LPC

• Durable Medical Equipment & Medical Supplies in Coppell, TX
• Providers in Coppell, 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 May 8, 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.