Staywell Medical Supplies

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1463747 Issued in NY

Legal business name

STAYWELL MEDICAL SUPPLIES

Practice address

18836 Jamaica Ave
Jamaica, NY 11423-2512

Phone

(718) 740-0200

Fax

(718) 740-0202

NPI assigned

Mar 22, 2013

Organization subpart

No

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

Authorized official

Name

Miss Caroline Ezeogu

Title

Ceo

Phone

(718) 415-0311

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1588906960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18836 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232512",
            "telephone_number": "718-740-0200",
            "fax_number": "718-740-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18836 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114232512",
            "telephone_number": "718-740-0200",
            "fax_number": "718-740-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAYWELL MEDICAL SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-22",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "EZEOGU",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-415-0311",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "1463747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Arielle Starker, DPT
• Barbara H. Starks, MS,CDN
• John Starner
• State of New York Comptrollers Office
• David Statman, PHD
• Angela Stazzone, LMSW
• Marcy Renee Stein-Albert, MD
• Andrew David Stein, LCSW
• Sandra Stein, MS, RD, CDE, CDN
• Katherine Steketee

• All providers in Jamaica, NY
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.