NPIMap

Organization Active NPI

Carelinc Medical Equipment & Supply Co LLC

  • Durable Medical Equipment & Medical Supplies
  • Portage, MI
National Provider Identifier
1386654689
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CARELINC MEDICAL EQUIPMENT & SUPPLY CO LLC
Practice address
5125 Portage Rd
Portage, MI 49002-1711
Phone
(269) 342-0141
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Derek Damstra
Title
President
Phone
(616) 249-2273

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X
Nursing Facility Supplies (DME) 332BN1400X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

5125 Portage Rd
Portage, MI 49002-1711

Mailing address

89 54TH St SW
Grand Rapids, MI 49548-5609

Other identifiers 2

IdentifierTypeStateIssuer
4919690MedicaidMI
540D10532OtherMIBLUE CROSS BLUE SHEILD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930040622 MI DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 8123149978 Practice locations: Kalamazoo, MI

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Carelinc Medical Equipment & Supply5125 Portage Rd, Kalamazoo, MI 49002-1798(269) 273-5500 Automatic Ext Defibrillator (AEDS) and/or Supplies|Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Contracture Treatment Devices: Dynamic Splint|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Gastric Suction Pumps|Heat & Cold Applica… Does not accept assignmentParticipating since Mar 31, 2000

National Provider Directory

National Provider Directory
Tax ID family
Carelinc Medical Equipment Supply Co LLC27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1250 Perry Ave
Ste D
Big Rapids, MI 49307
Phone (231) 796-6623

1015 S Beacon Blvd
Grand Haven, MI 49417

3228 W Carleton Rd
Hillsdale, MI 49242
Phone (517) 437-3226

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1386654689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 54TH ST SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495485609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 PORTAGE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021711",
            "telephone_number": "269-342-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARELINC MEDICAL EQUIPMENT & SUPPLY CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "DAMSTRA",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-249-2273"
    },
    "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": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "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
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4919690",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "540D10532",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.