Street Home Medical, Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

62133 Issued in GA

Legal business name

STREET HOME MEDICAL, INC

Practice address

1544 Watson Blvd
Warner Robins, GA 31093-3432

Phone

(478) 922-2889

Fax

(478) 922-9120

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ronald Scott Street

Title

C.E.O.

Phone

(478) 922-2889

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1467497347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1544 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933432",
            "telephone_number": "478-922-2889",
            "fax_number": "478-922-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933432",
            "telephone_number": "478-922-2889",
            "fax_number": "478-922-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREET HOME MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "478-922-2889",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "GA",
            "license": "62133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000545982A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Marie Stilwell, LMFT
• Lynne Stone, CRNA
• Heather Story
• Stacey A. Stout, CNM
• Mark Andrew Strandburg, DMD
• Alan Gadson Struth, M.D.
• Gail Andrea Stuart, L.PN
• Marlyn Brittany Stubbs
• Rhonda Stubbs
• Misty Stuckey

• Oxygen Equipment & Supplies (DME) in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Oxygen Equipment & Supplies (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.