Universal Medical Supply Corp

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

UNIVERSAL MEDICAL SUPPLY CORP

Doing business as

Unimed

Practice address

1626 S 8TH St
Rogers, AR 72756-5909

Phone

(479) 936-8487

Fax

(479) 936-8222

NPI assigned

Aug 21, 2006

Last updated

Feb 23, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

UNIVERSAL MEDICAL SUPPLY CORPAs reported in NPPES

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

Authorized official

Name

Mr. Jerry Dean Cook

Title

Owner

Phone

(479) 936-8487

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Unimed Doing business as

Part of

Universal Medical Supply Corp

Locations

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1952417156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 S 8TH ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727565909",
            "telephone_number": "479-936-8487",
            "fax_number": "479-936-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 S 8TH ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727565909",
            "telephone_number": "479-936-8487",
            "fax_number": "479-936-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL MEDICAL SUPPLY CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSAL MEDICAL SUPPLY CORP",
        "enumeration_date": "2006-08-21",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-936-8487",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131093716",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS PHARMACY LICENSE",
            "identifier": "056161",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "625882709",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unimed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabriel Chad Underwood, CRNA
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• Kerry Ann Underwood, MS, LPC, LMFT
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• Lyle Uttley

• Customized Equipment (DME) in Rogers, AR
• Providers in Rogers, AR by specialty
• Customized Equipment (DME) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.