Active NPI
Andrew Development Company, Inc.
- Customized Equipment (DME)
- Jasper, AL
National Provider Identifier
1871183350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- Legal business name
- ANDREW DEVELOPMENT COMPANY, INC.
- Practice address
- 1802 Alabama Ave
Jasper, AL 35501-5422 - Phone
- (205) 265-2617
- Fax
- (205) 265-2616
- NPI assigned
- Jan 19, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert Terry Wilson Jr.
- Title
- President
- Phone
- (205) 265-2617
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | Primary |
Addresses
Primary practice location
1802 Alabama Ave
Jasper, AL 35501-5422
Mailing address
1802 Alabama Ave
Jasper, AL 35501-5422
Phone (205) 265-2617
Other names 1
- Community Medical Systems
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL, GA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210122002722 | AL | Part B Supplier - Mass Immunization (Roster Biller Only) | 3779997242 | Practice locations: Jasper, AL |
| O20210128002848 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 3779997242 | Practice locations: Atlanta, GA |
National Provider Directory
National Provider Directory- Tax ID family
- Community Medical Systems
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Customized Equipment (DME)
- Birmingham, AL
- NPI 1548851736
Locations
1 Georgia Dome Dr NW
Atlanta, GA 30313
Phone (205) 522-9155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611014400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1611014400000",
"number": "1871183350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 ALABAMA AVE",
"city": "JASPER",
"state": "AL",
"postal_code": "355015422",
"telephone_number": "205-265-2617",
"fax_number": "205-265-2616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 ALABAMA AVE",
"city": "JASPER",
"state": "AL",
"postal_code": "355015422",
"telephone_number": "205-265-2617",
"fax_number": "205-265-2616"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANDREW DEVELOPMENT COMPANY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-19",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A",
"authorized_official_last_name": "WILSON",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "TERRY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "205-265-2617",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Community Medical Systems",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Jasper, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.