Organization Active NPI

Andrew Development Company, Inc.

  • Customized Equipment (DME)
  • Jasper, AL
National Provider Identifier
1871183350
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
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

Updated by the provider on Jan 19, 2021

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 Systems2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

Verify at the official NPI Registry.