Individual provider Active NPI

Henry Hajek

  • Durable Medical Equipment & Medical Supplies
  • Tuscaloosa, AL
National Provider Identifier
1730658261
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
R008243707 Issued in AL
Practice address
6130 Old Greensboro Rd
Tuscaloosa, AL 35405-5923
Phone
(205) 394-6917
Fax
(205) 278-6748
NPI assigned
Nov 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X R008243707 AL Primary

Addresses

Primary practice location

6130 Old Greensboro Rd
Tuscaloosa, AL 35405-5923

Mailing address

6130 Old Greensboro Rd
Tuscaloosa, AL 35405-5923
Phone (205) 394-6917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R008243707ALMDDurable Medical Equipment & Medical Supplies

Practice roles

OrganizationSpecialtyStatusNew patients
Tuscaloosa Supply Company, Inc Durable Medical Equipment & Medical Supplies PastSince Sep 15, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1730658261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 OLD GREENSBORO RD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354055923",
            "telephone_number": "205-394-6917",
            "fax_number": "205-278-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 OLD GREENSBORO RD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354055923",
            "telephone_number": "205-394-6917",
            "fax_number": "205-278-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJEK",
        "first_name": "HENRY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "R008243707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.