NPIMap

Organization Active NPI

Medstar Medical Supplies LLC

  • Dialysis Equipment & Supplies (DME)
  • Bridgeport, WV
National Provider Identifier
1699702126
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dialysis Equipment & Supplies (DME)Taxonomy code 332BD1200X
Legal business name
MEDSTAR MEDICAL SUPPLIES LLC
Practice address
166 Thompson Dr
Bridgeport, WV 26330-1644
Phone
(304) 842-6001
Fax
(304) 842-6111
NPI assigned
Jun 28, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Marcy D LongNPI 1992730329
Title
Administrative Assistant
Phone
(304) 842-6001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dialysis Equipment & Supplies (DME) 332BD1200X WV Primary

Addresses

Primary practice location

166 Thompson Dr
Bridgeport, WV 26330-1644

Mailing address

166 Thompson Dr
Bridgeport, WV 26330-1644
Phone (304) 842-6001

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1699702126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 THOMPSON DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301644",
            "telephone_number": "304-842-6001",
            "fax_number": "304-842-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 THOMPSON DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301644",
            "telephone_number": "304-842-6001",
            "fax_number": "304-842-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "MARCY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "304-842-6001"
    },
    "taxonomies": [
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.