Brazos Medical Supply, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

S4451904 Issued in VA

Legal business name

BRAZOS MEDICAL SUPPLY, LLC

Practice address

2005 Old Greenbrier Rd
Suite #106
Chesapeake, VA 23320-2649

Phone

(757) 675-6400

NPI assigned

Mar 26, 2013

Last updated

Mar 26, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Ray CrumNPI 1811234305

Title

Vice President/Coo

Phone

(757) 675-6400

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Ray Crum

  • Sleep Specialist (PhD)
  • Suffolk, VA
  • NPI 1811234305
  Authorized official Same address or phone

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1497097612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 OLD GREENBRIER RD",
            "address_2": "SUITE #106",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202649",
            "telephone_number": "757-675-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 OLD GREENBRIER RD",
            "address_2": "SUITE #106",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202649",
            "telephone_number": "757-675-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "CRUM",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "VICE PRESIDENT/COO",
        "authorized_official_telephone_number": "757-675-6400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "VA",
            "license": "S4451904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oxygen Equipment & Supplies (DME) in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Oxygen Equipment & Supplies (DME) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.