Penrod Medical Equipment, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

00829 Issued in NC

Legal business name

PENROD MEDICAL EQUIPMENT, LLC

Practice address

1806 W Innes St
Salisbury, NC 28144-2554

Phone

(704) 630-1155

Fax

(888) 462-4916

NPI assigned

May 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Craig Stanley Rae

Title

Partner / Member

Phone

(704) 630-1155

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1700836806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 W INNES ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442554",
            "telephone_number": "704-630-1155",
            "fax_number": "888-462-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 W INNES ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442554",
            "telephone_number": "704-630-1155",
            "fax_number": "888-462-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENROD MEDICAL EQUIPMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "STANLEY",
        "authorized_official_title_or_position": "PARTNER / MEMBER",
        "authorized_official_telephone_number": "704-630-1155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "00829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7703906",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VGM GROUP COMPANY",
            "identifier": "V21893",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.