Mid South Medical Equipment

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MID SOUTH MEDICAL EQUIPMENT

Practice address

501 Falls Blvd S
Wynne, AR 72396-3513

Phone

(870) 238-4242

Fax

(870) 238-4035

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert D Bethell Jr.

Title

Owner

Phone

(870) 238-4242

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1902963994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1067",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723961067",
            "telephone_number": "870-238-4242",
            "fax_number": "870-238-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963513",
            "telephone_number": "870-238-4242",
            "fax_number": "870-238-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH MEDICAL EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "BETHELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-238-4242",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "49769",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143588716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Massey, PHARM.D.
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• Willie Eugene McMahan Jr., PTA
• Michael O Norris OD PA
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• Michael S. Miller, LPC
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• Mitchell Eye Clinic PA Inc
• Billy J Mitchell Jr., O.D.

• Durable Medical Equipment & Medical Supplies in Wynne, AR
• Providers in Wynne, AR by specialty
• Durable Medical Equipment & Medical Supplies in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.