NPIMap

Organization Active NPI

MDK Ventures L.L.C.

Doing business as Medical Department Store

  • Durable Medical Equipment & Medical Supplies
  • Naples, FL
National Provider Identifier
1417358334
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MDK VENTURES L.L.C.
Doing business as
Medical Department Store
Practice address
13030 Livingston Rd
Ste 2
Naples, FL 34105-5024
Phone
(239) 529-2242
Fax
(239) 776-7809
NPI assigned
Sep 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Authorized official

Name
Mr. Kevin William McCord
Title
General Manager
Phone
(941) 584-6154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

13030 Livingston Rd
Ste 2
Naples, FL 34105-5024

Mailing address

1180 Jacaranda Blvd
Venice, FL 34292-4501
Phone (941) 584-6154

Other names 1

  • Medical Department Store Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MDK Ventures LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

13030 Livingston Rd
Ste 2
Naples, FL 34105
Phone (239) 529-2242

NPI Registry JSON

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1417358334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 JACARANDA BLVD",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342924501",
            "telephone_number": "941-584-6154",
            "fax_number": "941-584-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13030 LIVINGSTON RD",
            "address_2": "STE 2",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341055024",
            "telephone_number": "239-529-2242",
            "fax_number": "239-776-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDK VENTURES L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-10",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "MCCORD",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "941-584-6154",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Department Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.