Homebound Medical Supply Co

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

00062 Issued in NC

Legal business name

HOMEBOUND MEDICAL SUPPLY CO

Practice address

615 E Southerland St
Wallace, NC 28466-0070

Phone

(910) 285-4410

Fax

(910) 285-7505

NPI assigned

Aug 31, 2005

Last updated

Mar 16, 2012By 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

Mr. Horace Vernon Pigford Jr.NPI 1417927773

Title

President

Phone

(910) 285-4410

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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.

• Horace Vernon Pigford Jr., PT

  • Physical Therapist
  • Wallace, NC
  • NPI 1417927773
  NPD (past) Authorized official

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1700879194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "address_2": "615 E SOUTHERLAND ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284660070",
            "telephone_number": "910-285-4410",
            "fax_number": "910-285-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E SOUTHERLAND ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284660070",
            "telephone_number": "910-285-4410",
            "fax_number": "910-285-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEBOUND MEDICAL SUPPLY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "PIGFORD",
        "authorized_official_first_name": "HORACE",
        "authorized_official_middle_name": "VERNON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-285-4410",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "00062",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NC",
            "license": "00062",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NC",
            "license": "00062",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700037",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "0495W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Wallace, NC
• Providers in Wallace, 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 Mar 16, 2012; 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.