Active NPI
Tristate Medical Supply LLC
- Oxygen Equipment & Supplies (DME)
- Dothan, AL
National Provider Identifier
1407908437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oxygen Equipment & Supplies (DME)
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106600 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930021117 | AL | DME Supplier - Medical Supply Company | 1951506237 | Practice locations: Dothan, AL |
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Tristate Medical Supply LLC | 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 assignment |
National Provider Directory
National Provider DirectoryLocations
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.