NPIMap

Organization Active NPI

Agawam Medical Supply Corp

  • Durable Medical Equipment & Medical Supplies
  • Agawam, MA
National Provider Identifier
1700958857
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AGAWAM MEDICAL SUPPLY CORP
Practice address
56 Abrams Drive
Agawam, MA 01001
Phone
(413) 789-1100
Fax
(413) 786-9201
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Anthony Dean Saracino
Title
President
Phone
(413) 789-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

56 Abrams Drive
Agawam, MA 01001

Mailing address

56 Abrams Drive
Agawam, MA 01001
Phone (413) 789-1100

Other identifiers 4

IdentifierTypeStateIssuer
355154OtherMABCBS
003091676MedicaidCT
110029278BMedicaidMA
1535706MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930065649 MA DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic-Prosthetic 1759401557 Practice locations: Agawam, MA

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Agawam Medical Supply Inc56 Abrams Dr, Agawam, MA 01001-2934(413) 789-1100 Commodes, Urinals, Bedpans|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Pneumatic Compression Devices and/or Supplies|Support Surfaces: Pressure Reducing Beds/Mats/Pads|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Ultraviolet Light Devices and/or Su… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

838 Suffield St
Agawam, MA 01001

56 General Abrams Dr
Agawam, MA 01001
Phone (413) 789-1100

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1700958857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 ABRAMS DRIVE",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "01001",
            "telephone_number": "413-789-1100",
            "fax_number": "413-786-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 ABRAMS DRIVE",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "01001",
            "telephone_number": "413-789-1100",
            "fax_number": "413-786-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAWAM MEDICAL SUPPLY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "SARACINO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-789-1100"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "355154",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003091676",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110029278B",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1535706",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Agawam, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.