Quad County Home Medical Supplies & Equipment

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

203000103 Issued in NU

Legal business name

QUAD COUNTY HOME MEDICAL SUPPLIES & EQUIPMENT

Practice address

8 Huber St
Pana, IL 62557-1721

Phone

(217) 562-6362

Fax

(217) 562-6395

NPI assigned

Mar 21, 2007

Last updated

Nov 17, 2016By 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. James E Moon

Title

Chief Financial Officer

Phone

(217) 562-2131

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Pana Community Hospital Association

  • Critical Access Hospital
  • Pana, IL
  • NPI 1942326970

  Member Of

  NPD member

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1740306885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 HUBER ST",
            "city": "PANA",
            "state": "IL",
            "postal_code": "625571721",
            "telephone_number": "217-562-6362",
            "fax_number": "217-562-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 HUBER ST",
            "city": "PANA",
            "state": "IL",
            "postal_code": "625571721",
            "telephone_number": "217-562-6362",
            "fax_number": "217-562-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD COUNTY HOME MEDICAL SUPPLIES & EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "217-562-2131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": "203000103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pana Health and Rehab Center LLC
• Pana Health and Rehab Center LLC
• Pana Medical Group
• Laura Pauley
• Progressive Housing, Inc. (Park Place)
• Deogracias F Quizon, MD
• Coleen Karen Rakers, ANP-BC
• Rose Garden of Pana, LLC (Rose Garden of Pana)
• RX Stores LLC (Sav Mor Pharmacy)
• Kaitlyn Rzasa, MS, RDN, LDN

• Durable Medical Equipment & Medical Supplies in Pana, IL
• Providers in Pana, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.