PRESTIGE MEDICAL SUPPLY INC (NPI# 1366879603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366879603 |
Entity Type | Organization |
Organization Name | PRESTIGE MEDICAL SUPPLY INC |
Practice Address |
2224 Conrad Dr Ste A Jonesboro AR 72401-7222 |
Practice Telephone | 8774721102 |
Practice Fax Number | 8886823526 |
Mailing Telephone | 8774721102 |
Mailing Fax Number | 8886823526 |
Enumeration Date | 2013-10-01 |
Last Update Date | 2020-01-28 |
Authorized Official Name | TERRY SCOTT GENTRY (OWNER) |
Authorized Official Telephone | 8774721102 |
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 |
---|---|---|---|---|
1467686485 | Prestige Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 235 Malcolm X Blvd, Brooklyn, NY 11233-1174 | 2009-05-05 |
Street Address |
2224 CONRAD DR STE A |
City | JONESBORO |
State | AR |
Zip Code | 72401-7222 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
Find all providers in zip 72401 |
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 |
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 |
1346545662 | Lavorne Blyden-green | Durable Medical Equipment & Medical Supplies | 7733 Town Ct, Jonesboro, GA 30236-2395 | 2011-01-18 |
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.