MEDSTAR DIABETIC SUPPLY, LP (NPI# 1164460747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164460747 |
| Entity Type | Organization |
| Organization Name | MEDSTAR DIABETIC SUPPLY, LP |
| Other Organization Name | CCS MEDICAL |
| Practice Address |
3939 W. Green Oaks Blvd #205 Arlington TX 76016-2793 |
| Mailing Address |
1505 Lbj Fwy Ste 550 Farmers Branch TX 75234-6069 |
| Practice Telephone | 8665355556 |
| Practice Fax Number | 8665355456 |
| Mailing Telephone | 9726282100 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2019-10-17 |
| Authorized Official Name | MICHAEL CAPONE (SECRETARY) |
| Authorized Official Telephone | 9726282100 |
| Is Organization Subpart | Y |
| Parent Organization Name | CCS MEDICAL HOLDINGS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 009938430 | 05 | |
| TX | 017085402 | 05 | |
| GA | 003115736A | 05 | |
| AR | 141003716 | 05 | |
| TX | 017085401 | 05 | |
| NM | 55424279 | 05 | |
| TX | 017085403 | 05 | |
| OK | 100815120A | 05 | |
| LA | 1450901 | 05 |
| Other Name | Type Code |
|---|---|
| CCS Medical | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MEDSTAR DIABETIC SUPPLY, LP | 1505 Lbj Fwy Ste 550, Farmers Branch, TX 75234 |
| Colorado Business Entities | MedStar Diabetic Supply, LP | 6655 W Jewell Ave Ste 214, Lakewood, CO 80232 |
| Street Address |
3939 W. GREEN OAKS BLVD #205 |
| City | ARLINGTON |
| State | TX |
| Zip Code | 76016-2793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427655646 | Kristin Allison Healer | Counselor | 5614 Arbor Valley Drive, Arlington, TX 76016 | 2020-10-01 |
| 1720564040 | Malesco LLC | Durable Medical Equipment & Medical Supplies | 2805 W. Arkansas Ln #300, Arlington, TX 76016 | 2018-07-19 |
| 1174034623 | Stat Trauma & Surgical Services, Pllc | Surgery | 6 Garden Ln, Arlington, TX 76016 | 2017-10-23 |
| 1689197626 | Ortho Pain Solutions, LLC | Durable Medical Equipment & Medical Supplies | 2805 W Arkansas Ln Ste 300, Arlington, TX 76016 | 2017-07-21 |
| 1710382924 | Christopher Matthew Lemoine | Specialist/Technologist | 4501 W. Pleasant Ridge, Martin High School, Arlington, TX 76016 | 2014-10-30 |
| 1073936993 | Dariush Alirezaieyan | Specialist/Technologist, Other | 6601 Johns Crt, Arlington, TX 76016 | 2014-01-29 |
| 1063768380 | Melissa Kathleen Zawisza | Social Worker | 6311 Millwood Ct., Arlington, TX 76016 | 2012-07-24 |
| 1023377421 | Walter Ernest Williamson Jr. | Surgery | 4806 Wooded Acres Drive, Arlington, TX 76016 | 2012-05-07 |
| 1043585615 | Jack Henry Arlington, LLC | Alzheimer Center (Dementia Center) | 2300 Little Rd, Arlington, TX 76016 | 2012-03-15 |
| 1568608420 | Keorric Lamont Holiday | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3705 Fort Hunt Drive, Arlington, TX 76016 | 2008-12-26 |
| Find all providers in zip 76016 | ||||
| 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 |
|---|---|---|---|---|
| 1609494178 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 740 N Glebe Rd, Arlington, VA 22203-2257 | 2020-07-10 |
| 1255958229 | Patients Choice, LLC | Durable Medical Equipment & Medical Supplies | 719 W. Harris St., Suite B10, Arlington, TX 76001 | 2020-06-25 |
| 1013533314 | Arlington Orthopedic Associates, Pa | Durable Medical Equipment & Medical Supplies | 4100 N Collins St Ste 200, Arlington, TX 76005-4551 | 2020-06-23 |
| 1467077560 | Virginia Cvs Pharmacy L L C | Durable Medical Equipment & Medical Supplies | 750 N Glebe Rd, Arlington, VA 22203-4441 | 2020-06-15 |
| 1922621960 | Virginia Cvs Pharmacy L L C | Durable Medical Equipment & Medical Supplies | 4060 Campbell Ave, Arlington, VA 22206-3424 | 2020-05-26 |
| 1124649884 | Synergy Medical Sales LLC | Durable Medical Equipment & Medical Supplies | 2303 Roosevelt Dr Ste A, Arlington, TX 76016-5951 | 2020-05-04 |
| 1659928638 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2120 Washington Blvd Rm 115, Arlington, VA 22204-5718 | 2019-08-23 |
| 1639725112 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 950 S George Mason Dr, Arlington, VA 22204-1557 | 2019-08-12 |
| 1760945786 | Lexington Eye Associates - Optical | Durable Medical Equipment & Medical Supplies | 1040 Massachusetts Ave, Arlington, MA 02476-4315 | 2019-04-08 |
| 1720564040 | Malesco LLC | Durable Medical Equipment & Medical Supplies | 2805 W. Arkansas Ln #300, Arlington, TX 76016 | 2018-07-19 |
| Find all providers in ARLINGTON | ||||
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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.