Green Well Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GREEN WELL MEDICAL SUPPLY LLC

Practice address

9562 Hampton Reserve Dr
Brentwood, TN 37027-8491

Phone

(615) 513-1880

NPI assigned

Jan 8, 2011

Organization subpart

No

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

Authorized official

Name

Kirsten Leimbach

Title

Owner

Phone

(615) 513-1880

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1294444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294444800000",
    "number": "1639473440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9562 HAMPTON RESERVE DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9562 HAMPTON RESERVE DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278491",
            "telephone_number": "615-513-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN WELL MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-08",
        "last_updated": "2011-01-08",
        "status": "A",
        "authorized_official_last_name": "LEIMBACH",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-513-1880"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2011; 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.