Impact Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

IMPACT MEDICAL SUPPLY, LLC

Practice address

15 Wind Trace CT
The Woodlands, TX 77381-2651

Phone

(409) 402-4940

Fax

(409) 684-0343

NPI assigned

Dec 3, 2019

Organization subpart

No

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

Authorized official

Name

Marli Chapman

Title

Owner

Phone

(409) 402-4940

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1972140556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WIND TRACE CT",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773812651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WIND TRACE CT",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773812651",
            "telephone_number": "409-402-4940",
            "fax_number": "409-684-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "MARLI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-402-4940"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.