Parkmor Drug Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PARKMOR DRUG INC.

Doing business as

Park Home Medical Equipment

Practice address

1501 S Main St
Goshen, IN 46526-4719

Phone

(574) 533-0626

Fax

(574) 533-8948

NPI assigned

Apr 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Randy Christophel, CPA,MBA

Title

Executive Vice President and Cfo

Phone

(574) 533-2141

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Park Home Medical Equipment Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Goshen Health System Inc

  • Radiology Clinic/Center
  • Goshen, IN
  • NPI 1588190284

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811952039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S MAIN ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264719",
            "telephone_number": "574-533-0626",
            "fax_number": "574-533-8948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S MAIN ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264719",
            "telephone_number": "574-533-0626",
            "fax_number": "574-533-8948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKMOR DRUG INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHRISTOPHEL",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "574-533-2141",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA,MBA"
    },
    "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": "ANTHEM",
            "identifier": "000000097204002",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sonya Overman
• Christopher John Owens, MD
• Sheila Kay Owens, COTA
• Victoria L.S. Owens, MD
• Sara J Paige, DMD
• Archana Patel, M.D.
• Paul H Buller MD
• Carly Michelle Paulus
• Hannah Leigh Pechin, DDS
• Thomas Pechin III, M.D.

• Durable Medical Equipment & Medical Supplies in Goshen, IN
• Providers in Goshen, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.