Active NPI
Sartin'S Vital Care, Inc.
- Durable Medical Equipment & Medical Supplies
- Gulfport, MS
National Provider Identifier
1932133196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 08961 1/2.1
- Legal business name
- SARTIN'S VITAL CARE, INC.
- Practice address
- 1311 Broad Ave
Gulfport, MS 39501 - Phone
- (228) 864-7056
- Fax
- (228) 864-2402
- NPI assigned
- Jul 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alvin Sartin
- Title
- Pres
- Phone
- (228) 864-7056
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 08961 1/2.1 | MS | Primary |
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | 08961 1/2.1 | MS | |
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 08961/2.1 | MS | |
| Home Infusion Therapy Pharmacy | 3336H0001X | |||
| Specialty Pharmacy | 3336S0011X | 08961 1/2.1 | MS |
Addresses
Primary practice location
1311 Broad Ave
Gulfport, MS 39501
Mailing address
1311 Broad Ave
Gulfport, MS 39501-2419
Phone (228) 864-7056
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00040011 | Medicaid | MS | |
| 2132187 | Other | PK |
Other names 1
- Sartins Vital Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110920000478 | MS | DME Supplier - Pharmacy | 8820061781 | Practice locations: Gulfport, MS |
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Sartins Vital Care Inc | Epoetin|Immunosuppressive Drugs|Infusion Drugs|External Infusion Pumps and/or Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies | Accepts assignment |
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Locations
4300 15th St
#A
Gulfport, MS 39501
Phone (228) 864-7056
4300 15th St
Ste 3
Gulfport, MS 39501
Phone (228) 864-7056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1532476800000",
"number": "1932133196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 BROAD AVE",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395012419",
"telephone_number": "228-864-7056",
"fax_number": "228-864-2402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 BROAD AVE",
"city": "GULFPORT",
"state": "MS",
"postal_code": "39501",
"telephone_number": "228-864-7056",
"fax_number": "228-864-2402"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SARTIN'S VITAL CARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-11",
"last_updated": "2018-07-25",
"status": "A",
"authorized_official_last_name": "SARTIN",
"authorized_official_first_name": "ALVIN",
"authorized_official_title_or_position": "PRES",
"authorized_official_telephone_number": "228-864-7056"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "MS",
"license": "08961 1/2.1",
"primary": true
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": "MS",
"license": "08961 1/2.1",
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MS",
"license": "08961/2.1",
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": "MS",
"license": "08961 1/2.1",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00040011",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2132187",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sartins Vital Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Sartins Vital Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.