MRS. LAVORNE BLYDEN-GREEN (NPI# 1346545662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346545662 |
| Entity Type | Individual |
| Full Name | MRS. LAVORNE BLYDEN-GREEN |
| Practice Address |
7733 Town Ct Jonesboro GA 30236-2395 |
| Mailing Address |
Po Box 2312 Jonesboro GA 30237-2312 |
| Practice Telephone | 4047818166 |
| Mailing Telephone | 4047818166 |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2011-01-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| N | 332BD1200X |
Durable Medical Equipment & Medical Supplies Specialization: Dialysis Equipment & Supplies |
Suppliers | ||
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers | ||
| N | 332U00000X | Home Delivered Meals | Suppliers | ||
| N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers | ||
| N | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Suppliers | ||
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Street Address |
7733 TOWN CT |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236-2395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| 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 |
|---|---|---|---|---|
| 1497363436 | Just Like You Post-mastectomy Fitting Boutique | Durable Medical Equipment & Medical Supplies | 2913 King St Ste 3, Jonesboro, AR 72401-5353 | 2020-07-15 |
| 1700334455 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 110 Southwest Drive, Jonesboro, AR 72401-5827 | 2016-09-12 |
| 1972907582 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2811 Creek Dr, Jonesboro, AR 72401-5377 | 2014-10-13 |
| 1962806620 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 3319 Harrisburg Rd, Jonesboro, AR 72404-8782 | 2014-10-09 |
| 1801215264 | Willie Murray | Durable Medical Equipment & Medical Supplies | 709 Belle Grove Dr, Jonesboro, GA 30238-4167 | 2014-04-14 |
| 1366879603 | Prestige Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 2224 Conrad Dr Ste A, Jonesboro, AR 72401-7222 | 2013-10-01 |
| 1790125938 | Marshall World Empire Coach/n.e.t. | Durable Medical Equipment & Medical Supplies | 7737 Jonesboro Rd, Jonesboro, GA 30236-2418 | 2013-07-02 |
| 1477893949 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 2405 S Caraway Rd, Jonesboro, AR 72401-6208 | 2013-02-21 |
| 1386912020 | Amrod, Inc. | Durable Medical Equipment & Medical Supplies | 9456 S Main St, Suite D-2, Jonesboro, GA 30236-6072 | 2011-12-08 |
| 1982935060 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 1007 Windover, Ste B, Jonesboro, AR 72401 | 2010-01-29 |
| Find all providers in JONESBORO | ||||
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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.