Medical Supplies on Main Street

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDICAL SUPPLIES ON MAIN STREET

Practice address

204 Main St
Barnesville, GA 30204-1468

Phone

(770) 358-0909

Fax

(770) 358-0095

NPI assigned

Jul 5, 2006

Last updated

Jul 23, 2008By 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. Olivia H. Banks

Title

Owner

Phone

(770) 358-0909

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1770514135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MAIN ST",
            "city": "BARNESVILLE",
            "state": "GA",
            "postal_code": "302041468",
            "telephone_number": "770-358-0909",
            "fax_number": "770-358-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MAIN ST",
            "city": "BARNESVILLE",
            "state": "GA",
            "postal_code": "302041468",
            "telephone_number": "770-358-0909",
            "fax_number": "770-358-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SUPPLIES ON MAIN STREET",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-358-0909",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "973262504A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Barnesville, GA
• Providers in Barnesville, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.