Star Valley Medical Supply LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

STAR VALLEY MEDICAL SUPPLY LLC

Practice address

32 East 4TH Ave
Afton, WY 83110-1676

Phone

(307) 885-0005

Fax

(307) 885-0045

NPI assigned

Mar 7, 2013

Last updated

Apr 12, 2021By 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

Mrs. Rebecca Erickson, BS

Title

Owner

Phone

(307) 885-0005

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

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

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.

• Clint R Erickson, D.C.

  • Chiropractor
  • Afton, WY
  • NPI 1417187519
  NPD (past)

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1740521335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1676",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831101676",
            "telephone_number": "307-885-0005",
            "fax_number": "307-885-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 EAST 4TH AVE",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831101676",
            "telephone_number": "307-885-0005",
            "fax_number": "307-885-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR VALLEY MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-885-0005",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B08077831",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Star Valley Dental 1 LLC
• Star Valley Dental LLC
• Star Valley Drug Co (Valley Pharmacy)
• Star Valley Healthcare, Inc. (Symbii Home Health)
• Star Valley Healthcare, Inc. (Symbii Hospice)
• Star Valley Senior Center Inc
• Starshine Inc.
• Sterling Provider Group
• Noel B Stibor, M.D.
• Kevin L Stucki, DO

• Oxygen Equipment & Supplies (DME) in Afton, WY
• Providers in Afton, WY by specialty
• Oxygen Equipment & Supplies (DME) in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.