Extended Medical, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EXTENDED MEDICAL, INC

Practice address

110 North Highway J
Hayti, MO 63851

Phone

(573) 359-0403

Fax

(573) 359-2136

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Glenn D Haynes

Title

Ceo

Phone

(573) 359-2930

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• EHS MEDICAL EQUIPMENT & SUPPLIES Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Muhammad Naseeruddin, M.D.

  • Internal Medicine Physician
  • Hayti, MO
  • NPI 1194849224
  NPD (past)
• Suzanne Steele, LCSW

  • Clinical Social Worker
  • Kennett, MO
  • NPI 1205712262
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1811016249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 393",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "638510393",
            "telephone_number": "573-359-2473",
            "fax_number": "573-359-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NORTH HIGHWAY J",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "63851",
            "telephone_number": "573-359-0403",
            "fax_number": "573-359-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-359-2930"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK DME NUMBER",
            "identifier": "684749",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "628892507",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EHS MEDICAL EQUIPMENT & SUPPLIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Extended Home Care, Inc
• Extended Home Care, Inc.
• Vicky Lynne Fairey, RN,C
• Family Counseling Center
• Family Counseling Center, Inc.
• Family Counseling Center, Inc.
• Shanice Fane

• All providers in Hayti, MO
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.