NPIMap

Organization Active NPI

Life Supply Corp

  • Durable Medical Equipment & Medical Supplies
  • Ludlow, MA
National Provider Identifier
1831192061
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LIFE SUPPLY CORP
Practice address
280 Moody St
Ludlow, MA 01056-1244
Phone
(413) 593-5555
Fax
(413) 593-9530
NPI assigned
May 23, 2005
Last updated
Jan 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Authorized official

Name
Mr. Joseph Smith
Title
Ceo President
Phone
(203) 239-1002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

280 Moody St
Ludlow, MA 01056-1244

Mailing address

280 Moody St
Ludlow, MA 01056-1244
Phone (413) 593-5555

Other identifiers 3

IdentifierTypeStateIssuer
1537687MedicaidMA
003104429MedicaidCT
378354OtherMABC BS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930003049 MA DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 7911028972 Practice locations: Ludlow, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Life Supply Corp280 Moody St, Ludlow, MA 01056-12444135935555106 Enteral Nutrients|Enteral Equipment and/or Supplies|Continuous Positive Airway Pressure (CPAP) Devices|High Freq Chest Wall Oscillation Devices/Supplies|Mechanical In-Exsufflation Devices|Nebulizer Equipment and/or Supplies|Oxygen Equipment and/or Supplies|Respiratory Assist Devices|Respiratory Suc… Does not accept assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory

Member of 1

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

Locations

143 Mill St
Leominster, MA 01453
Phone (978) 537-8707

280 Moody St
Ludlow, MA 01056
Phone (413) 583-8317

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1831192061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MOODY ST",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010561244",
            "telephone_number": "413-593-5555",
            "fax_number": "413-593-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MOODY ST",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010561244",
            "telephone_number": "413-593-5555",
            "fax_number": "413-593-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SUPPLY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "203-239-1002",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "1537687",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003104429",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PROVIDER NUMBER",
            "identifier": "378354",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludlow, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.