Raleigh Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

00430 Issued in NC

Legal business name

RALEIGH MEDICAL SUPPLY, LLC

Practice address

2601 Blue Ridge Rd
Raleigh, NC 27607-6481

Phone

(919) 781-2281

Fax

(919) 782-0360

NPI assigned

Jul 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Clarence Edward Lupton III

Title

Owner/Manager

Phone

(919) 781-2281

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1992905160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 BLUE RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076481",
            "telephone_number": "919-781-2281",
            "fax_number": "919-782-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 BLUE RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076481",
            "telephone_number": "919-781-2281",
            "fax_number": "919-782-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "LUPTON",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "919-781-2281",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "00430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7702986",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.