Prairie Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRAIRIE MEDICAL SUPPLY INC

Practice address

120 Lewis Park Dr
Mt Zion, IL 62549-1202

Phone

(217) 864-0738

Fax

(217) 864-0743

NPI assigned

Mar 14, 2006

Last updated

Aug 22, 2020By 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. Sharon S Mandli

Title

Owner

Phone

(217) 454-0479

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790754711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LEWIS PARK PLAZA",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "62549",
            "telephone_number": "217-864-0738",
            "fax_number": "217-864-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LEWIS PARK DR",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "625491202",
            "telephone_number": "217-864-0738",
            "fax_number": "217-864-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANDLI",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-454-0479",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "05827243",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mt. Zion Hearing Aid Center
• Megan Musick, M.P.T.
• Chris Nayor Ntor-Ue, DC LAC
• Julia A Paulson, D.M.D.
• Peter L Paulson, D.M.D.
• Russell John Proesel, DDS
• Dana Marie Ray, MD
• Jacob David Sams, MD
• Sanders Counseling PLLC
• Kayla Michelle Sheets, NP

• Durable Medical Equipment & Medical Supplies in Mt Zion, IL
• Providers in Mt Zion, 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 Aug 22, 2020; 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.