NPIMap

Organization Active NPI

Medworx Home Medical Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Ridgeland, MS
National Provider Identifier
1942505482
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MEDWORX HOME MEDICAL SUPPLIES LLC
Practice address
950 E County Line Rd
Suite C
Ridgeland, MS 39157-1928
Phone
(601) 665-4094
NPI assigned
Jan 13, 2011
Last updated
Oct 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Daron Walters
Title
Owner
Phone
(601) 573-9712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

950 E County Line Rd
Suite C
Ridgeland, MS 39157-1928

Mailing address

950 E County Line Rd
Suite C
Ridgeland, MS 39157-1928
Phone (601) 665-4094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121121000190 MS DME Supplier - Medical Supply Company 5698926624 Practice locations: Ridgeland, MS

National Provider Directory

National Provider Directory
Tax ID family
Medworx Home Medical Supplies LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

800 Woodlands Pkwy
Ste 207
Ridgeland, MS 39157
Phone (601) 665-4094

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1942505482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD",
            "address_2": "SUITE C",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-665-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD",
            "address_2": "SUITE C",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-665-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDWORX HOME MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "DARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-573-9712"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.