Northgate Services of Missouri LLC

Primary specialty

Nursing Facility Supplies (DME)Taxonomy code 332BN1400X

License

630016343 Issued in AL

Legal business name

NORTHGATE SERVICES OF MISSOURI LLC

Practice address

961 Fairfax Park
Tuscaloosa, AL 35406-2805

Phone

(205) 345-8858

Fax

(205) 345-7991

NPI assigned

Jul 3, 2006

Last updated

Oct 11, 2010By 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

Claude E Lee

Title

Vice President Cfo

Phone

(205) 391-3600

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286755200000",
    "number": "1407886732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 FAIRFAX PARK",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062805",
            "telephone_number": "205-345-8858",
            "fax_number": "205-345-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 FAIRFAX PARK",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062805",
            "telephone_number": "205-345-8858",
            "fax_number": "205-345-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHGATE SERVICES OF MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-10-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CLAUDE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT CFO",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "AL",
            "license": "630016343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009926990",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141656741",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Northstar EMS Inc. (Wheelchair Transport Services)
• Northstar EMS, Inc. (NorthStar Paramedic Serv-Tuscaloosa)

• Nursing Facility Supplies (DME) in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Nursing Facility Supplies (DME) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.