P & M Quality Medical LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

P & M QUALITY MEDICAL LLC

Practice address

102 N Main St
Monticello, AR 71655-4726

Phone

(870) 367-7456

Fax

(870) 367-7494

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Andrea Wagner

Title

Owner

Phone

(870) 723-3148

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1881885093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N MAIN ST",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554726",
            "telephone_number": "870-367-7456",
            "fax_number": "870-367-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N MAIN ST",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554726",
            "telephone_number": "870-367-7456",
            "fax_number": "870-367-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P & M QUALITY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-723-3148"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177464733",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175774716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oxygen Equipment & Supplies (DME) in Monticello, AR
• Providers in Monticello, AR by specialty
• Oxygen Equipment & Supplies (DME) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; 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.