Organization Active NPI

Tristate Medical Supply LLC

  • Oxygen Equipment & Supplies (DME)
  • Dothan, AL
National Provider Identifier
1407908437
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
TRISTATE MEDICAL SUPPLY LLC
Practice address
2253 Third Ave Ste 1
Dothan, AL 36301-5303
Phone
(334) 886-9111
Fax
(334) 323-7303
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Debra Casey
Title
Manager
Phone
(334) 886-9111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 786 AL
Oxygen Equipment & Supplies (DME) 332BX2000X Primary

Addresses

Primary practice location

2253 Third Ave Ste 1
Dothan, AL 36301-5303

Mailing address

2253 Third Ave Ste 1
Dothan, AL 36301-5303
Phone (334) 886-9111

Other identifiers 1

IdentifierTypeStateIssuer
106600MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930021117 AL DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 1951506237 Practice locations: Dothan, AL

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
Tristate Medical Supply LLC2253 Third Ave, Dothan, AL 36301-530333488691111001 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Hospital Beds (Electric)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Canes and/or Crutches|Patient Lifts|Seat Lift Mechanisms|Walkers|Wheelchairs (Stan… Accepts assignmentParticipating since Jun 4, 2007

National Provider Directory

National Provider Directory

Locations

2253 Third Ave
#1
Dothan, AL 36301
Phone (334) 712-3311

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1407908437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2253 THIRD AVE STE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363015303",
            "telephone_number": "334-886-9111",
            "fax_number": "334-886-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 THIRD AVE STE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363015303",
            "telephone_number": "334-886-9111",
            "fax_number": "334-323-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTATE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "334-886-9111"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "786",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106600",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.