Morrilton Respiratory Care Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MORRILTON RESPIRATORY CARE INC

Doing business as

Petit Jean Medical Supply

Practice address

8 Razorback Drive
Morrilton, AR 72110-0188

Phone

(501) 354-2700

Fax

(501) 354-0214

NPI assigned

Feb 23, 2007

Last updated

Feb 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bradley Rex White, C.PED, CFO

Title

President

Phone

(501) 354-2700

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PETIT JEAN MEDICAL SUPPLY Doing business as

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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1962537241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721100188",
            "telephone_number": "501-354-2700",
            "fax_number": "501-354-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RAZORBACK DRIVE",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721100188",
            "telephone_number": "501-354-2700",
            "fax_number": "501-354-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRILTON RESPIRATORY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "REX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-354-2700",
        "authorized_official_credential": "C.PED, CFO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154628716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PETIT JEAN MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Morrilton, AR
• Providers in Morrilton, 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 Feb 17, 2020; 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.