Knoact Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

800739368 Issued in MS

Legal business name

KNOACT MEDICAL SUPPLY

Practice address

322 E Railroad Ave
Crystal Springs, MS 39059-2848

Phone

(601) 879-4202

Fax

(769) 233-8683

NPI assigned

Dec 27, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Montreal Fairman

Title

Owner

Phone

(607) 879-4202

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514332800000",
    "number": "1417463530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 COLONIAL CIR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113206",
            "telephone_number": "601-879-4202",
            "fax_number": "769-233-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E RAILROAD AVE",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592848",
            "telephone_number": "601-879-4202",
            "fax_number": "769-233-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOACT MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-27",
        "last_updated": "2017-12-27",
        "status": "A",
        "authorized_official_last_name": "FAIRMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "MONTREAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-879-4202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "800739368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Crystal Springs, MS
• Providers in Crystal Springs, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; 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.