Southern Medical Supply

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

MG0842 Issued in KY

Legal business name

SOUTHERN MEDICAL SUPPLY

Practice address

625 Kentucky 980
Scottsville, KY 42164

Phone

(270) 239-3200

NPI assigned

Dec 27, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Jay Blankenship

Title

Owner

Phone

(270) 606-0663

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1457697146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 VETERANS MEMORIAL HWY",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "42164",
            "telephone_number": "270-239-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 KENTUCKY 980",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "42164",
            "telephone_number": "270-239-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-27",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-606-0663",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "KY",
            "license": "MG0842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Dean Shaw
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• Oxygen Equipment & Supplies (DME) in Scottsville, KY
• Providers in Scottsville, KY by specialty
• Oxygen Equipment & Supplies (DME) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.