Wilmington Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WILMINGTON MEDICAL SUPPLY, INC.

Practice address

3805 Crestwood Pkwy NW Ste 100
Duluth, GA 30096-7106

Phone

(678) 985-7246

Fax

(888) 718-0633

NPI assigned

Mar 31, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Jeffery B Hendrix

Title

Cfo

Phone

(405) 443-2985

Specialties & licenses 1

Addresses

Other names 1

• Advanced Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Wilmington Medical Supply Inc

  • Durable Medical Equipment & Medical Supplies
  • Wilmington, NC
  • NPI 1972558898

  5799805628

  Same PAC ID
• Wilmington Medical Supply, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Whitinsville, MA
  • NPI 1134416845

  5799805628

  Same PAC ID

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

Tax ID family

Wilmington Medical Supply Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Wilmington Medical Supply Inc

  • Durable Medical Equipment & Medical Supplies
  • Wilmington, NC
  • NPI 1972558898
  NPD tax ID
• Wilmington Medical Supply, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Whitinsville, MA
  • NPI 1134416845
  NPD tax ID

Locations

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1871956409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8516 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731626010",
            "telephone_number": "877-688-2729",
            "fax_number": "888-718-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 CRESTWOOD PKWY NW STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300967106",
            "telephone_number": "678-985-7246",
            "fax_number": "888-718-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "405-443-2985",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby Englishe Williams, RN
• Barbara Williamson
• Janet Williamson
• Ikeyshana Willis
• Jessie Nelson Willis, CCC-SLP
• Ashley Airelle Wilson, PA-C
• Barbara Mitchell Wilson, CRNFA
• Benjamin Wilson, PT, DPT
• Jill Wilson, LPC
• Nicole M Wilson, PHARMD, BCOP

• Durable Medical Equipment & Medical Supplies in Duluth, GA
• Providers in Duluth, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.