Greenway Medical Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GREENWAY MEDICAL INC.

Doing business as

Diabetes Source RX

Practice address

803 Coolidge Blvd
Suite 128
Lafayette, LA 70503-2376

Phone

(337) 267-7470

Fax

(866) 794-5729

NPI assigned

Oct 20, 2005

Last updated

Apr 23, 2009By 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

Mrs. Molly Mouton

Title

Vice President

Phone

(337) 267-7470

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• DIABETES SOURCE RX Doing business as

Locations

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240444800000",
    "number": "1609865773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52884",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052884",
            "telephone_number": "337-267-7470",
            "fax_number": "866-794-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 COOLIDGE BLVD",
            "address_2": "SUITE 128",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032376",
            "telephone_number": "337-267-7470",
            "fax_number": "866-794-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWAY MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2009-04-23",
        "status": "A",
        "authorized_official_last_name": "MOUTON",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "337-267-7470",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF LOUISIANA",
            "identifier": "G9723",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "519779",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010164401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011633701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467537",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIABETES SOURCE RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Durable Medical Equipment & Medical Supplies in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; 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.