NPIMap

Organization Active NPI

Restoration Healthcare of Commerce LLC

  • Durable Medical Equipment & Medical Supplies
  • Commerce, GA
National Provider Identifier
1740577949
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
078-665 Issued in GA
Legal business name
RESTORATION HEALTHCARE OF COMMERCE LLC
Practice address
70 Medical Center Dr
Commerce, GA 30529-1078
Phone
(706) 335-1000
Fax
(706) 335-4999
NPI assigned
Jul 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Authorized official

Name
Mr. Stephen N Clapp
Title
President/Ceo
Phone
(706) 335-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 078-665 GA Primary

Addresses

Primary practice location

70 Medical Center Dr
Commerce, GA 30529-1078

Mailing address

641 Hospital Rd Ste 1
Commerce, GA 30529-1155
Phone (706) 335-1000

Other identifiers 1

IdentifierTypeStateIssuer
000000151AMedicaidGA

Other names 1

  • NORTHRIDGE MEDICAL EQUIPMENT SUPPLY OF COMMERCE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
BJC Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

641 Hospital Rd
Ste 1
Commerce, GA 30529

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1740577949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 HOSPITAL RD STE 1",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291155",
            "telephone_number": "706-335-1000",
            "fax_number": "706-335-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER DR",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291078",
            "telephone_number": "706-335-1000",
            "fax_number": "706-335-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HEALTHCARE OF COMMERCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "CLAPP",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "706-335-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "078-665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000151A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHRIDGE MEDICAL EQUIPMENT SUPPLY OF COMMERCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Commerce, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.