Medical Supply DME LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDICAL SUPPLY DME LLC

Practice address

2400 Promenade Blvd Apt 2
Montgomery, AL 36106-4001

Phone

(470) 865-2445

NPI assigned

Feb 20, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Etta Starks

Title

Owner

Phone

(470) 865-2445

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1578020004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 PROMENADE BLVD APT 2",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361064001",
            "telephone_number": "470-865-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 PROMENADE BLVD APT 2",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361064001",
            "telephone_number": "470-865-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SUPPLY DME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "STARKS",
        "authorized_official_first_name": "ETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-865-2445",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Durable Medical Equipment & Medical Supplies in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; 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.