Promed Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROMED MEDICAL SUPPLY

Practice address

809 W Georgetown St
Crystal Springs, MS 39059-9474

Phone

(601) 281-5868

Fax

(662) 510-0231

NPI assigned

Apr 28, 2014

Organization subpart

No

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

Authorized official

Name

Janet K Sumrall

Title

Owner

Phone

(601) 281-5868

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1649680836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 W GEORGETOWN ST",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390599474",
            "telephone_number": "601-281-5868",
            "fax_number": "662-510-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 W GEORGETOWN ST",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390599474",
            "telephone_number": "601-281-5868",
            "fax_number": "662-510-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "SUMRALL",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-281-5868"
    },
    "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 Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.