DMTT LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

104850 Issued in AL

Legal business name

DMTT LLC

Practice address

17216 Highway 431
Wedowee, AL 36278-4574

Phone

(256) 357-4614

Fax

(256) 357-4641

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Jacob Prestenbach

Title

Ceo

Phone

(985) 447-3746

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• H&M DRUGS Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1891727111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 CANAL BLVD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015225",
            "telephone_number": "985-447-3746",
            "fax_number": "985-449-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17216 HIGHWAY 431",
            "city": "WEDOWEE",
            "state": "AL",
            "postal_code": "362784574",
            "telephone_number": "256-357-4614",
            "fax_number": "256-357-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMTT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "PRESTENBACH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "985-447-3746"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "104850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000227983C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161511",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168025",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147084",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "H&M DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carrollton Surgical Group, P. a.
• Shanda Cotney, CRNP
• Richard Daniel, CRNP
• Sarah Vanecia Davidson, CNP
• DMTT LLC
• Michael D Edwards, DMD
• Elite Rehab Wedowee LLC
• Family Pharmacy Inc
• H&M Drugs, Inc.
• Harris Lake Emergency Physicians LLC

• Community/Retail Pharmacy in Wedowee, AL
• Providers in Wedowee, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.