NICKES MEDICAL SUPPLY, LLC. (NPI# 1013579739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013579739 |
| Entity Type | Organization |
| Organization Name | NICKES MEDICAL SUPPLY, LLC. |
| Practice Address |
5405 E Granite St Bldg 2527 Tucson AZ 85707-3004 |
| Mailing Address |
2820 N Stanton St El Paso TX 79902-2509 |
| Practice Telephone | 5207454681 |
| Practice Fax Number | 5207454548 |
| Mailing Telephone | 9155338870 |
| Mailing Fax Number | 9155330078 |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |
| Authorized Official Name | NGOZI KATHLEEN AUSTIN-ELEJE (OWNER/ MANAGER) |
| Authorized Official Telephone | 9155338870 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1932761657 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 23640 N St # 758, Riverside, CA 92518-1893 | 2019-07-02 |
| 1619539335 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 5443 Dudley Blvd Bldg 911, Mcclellan, CA 95652-1013 | 2019-07-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NICKES MEDICAL SUPPLY, LLC | 2820 N Stanton St, El Paso, TX 79912-2509 |
| Street Address |
5405 E GRANITE ST BLDG 2527 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85707-3004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699128850 | Megan Dehaven | Specialist/Technologist | 5455 E Comanche St, Tucson, AZ 85707 | 2016-07-22 |
| 1780927954 | Ryan N Taylor | Physician Assistant | 400, 4175 S Alamo Ave, Davis-monthan Afb, AZ 85707 | 2013-04-05 |
| 1154658839 | Alisha A Marchetti | Physician Assistant | 4175 S. Alamo Avenue, 355th Mdg/mdos, Davis-monthan Afb, AZ 85707 | 2009-11-17 |
| 1851529192 | Christopher Thomas Yarbrough | Military Health Care Provider | 4625 South Phoenix Street Bldg 4843, Tucson, AZ 85707 | 2009-06-25 |
| 1144457045 | Denise Fabian | Psychiatry & Neurology | 5427 E. Madera Street, Davis Monthan Afb, AZ 85707 | 2009-06-17 |
| 1942437447 | Emerson M Earle | Military Health Care Provider | 4625 S. Phoenix St, Bld 4843, Tucson, AZ 85707 | 2009-06-11 |
| 1164657136 | Raul Romero | Military Health Care Provider | 4575 S. Phoenix St. 563rd Oss, Dmafb, AZ 85707 | 2009-05-20 |
| 1063647196 | Virginia E. Bailey | Military Health Care Provider | 4837 S Phoenix St., Rm 119 Davis-monthan Air Force Base, Tucson, AZ 85707 | 2009-05-19 |
| 1043417611 | Jacob Riis | Orthopaedic Surgery | 355 Mdg, 4175 South Alamo Ave, Tucson, AZ 85707 | 2007-06-28 |
| 1508989732 | Christopher E. Dunham | Physician Assistant | 4175 S. Alamo Ave Bldg 400, 355th Medical Group-davis Monthan Afb, Tucson, AZ 85707 | 2007-04-10 |
| Find all providers in zip 85707 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548801871 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 620 N Craycroft Rd Ste P, Tucson, AZ 85711-1448 | 2019-10-08 |
| 1760023097 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1021 E Palmdale St Ste 150-p, Tucson, AZ 85714-1857 | 2019-10-08 |
| 1811538002 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3875 N 1st Ave Ste B, Tucson, AZ 85719-1301 | 2019-09-30 |
| 1417417221 | Banner - University Medical Center Tucson Campus LLC | Durable Medical Equipment & Medical Supplies | 1501 N Campbell Ave Rm 6604, Tucson, AZ 85724-0001 | 2019-03-20 |
| 1649757352 | Brittany Newland | Durable Medical Equipment & Medical Supplies | 5350 E Broadway Blvd Ste 108, Tucson, AZ 85711-3722 | 2018-07-25 |
| 1588154157 | Banner Home Care Arizona | Durable Medical Equipment & Medical Supplies | 575 E River Rd Ste 104, Tucson, AZ 85704-5822 | 2018-05-18 |
| 1467952853 | Usa Medical Equipment and Supply | Durable Medical Equipment & Medical Supplies | 7916 E Colette Cir Unit 55, Tucson, AZ 85710-2495 | 2018-02-13 |
| 1104364157 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 831 E Fort Lowell Rd, Tucson, AZ 85719-2109 | 2017-02-09 |
| 1629524368 | Family First Senior Services | Durable Medical Equipment & Medical Supplies | 3837 N Forest Park Dr, Unit 122, Tucson, AZ 85718 | 2016-09-01 |
| 1275985145 | German Dobson Cvs LLC | Durable Medical Equipment & Medical Supplies | 2385 N Silverbell Rd, Tucson, AZ 85745-1121 | 2016-07-05 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.