MEDEMPORIUM, LLC (NPI# 1538143375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538143375 |
| Entity Type | Organization |
| Organization Name | MEDEMPORIUM, LLC |
| Practice Address |
1300 Crossbeam Dr Charlotte NC 28217-2800 |
| Practice Telephone | 7045352201 |
| Practice Fax Number | 7045353836 |
| Mailing Telephone | 7045352201 |
| Mailing Fax Number | 7045353836 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2010-04-05 |
| Authorized Official Name | MARYANN BISHOP LARGEN (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 7045352201 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
00358 | NC | Suppliers |
| N | 333600000X | Pharmacy | 7135 | NC | Suppliers |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 00358 | NC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7702784 | 05 | |
| NC | BLUE CROSS BLUE SHIELD | 04155 | 01 |
| Street Address |
1300 CROSSBEAM DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28217-2800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017798 | Kelby Rae Hurlocker | Specialist/Technologist | 500 Center Park Dr, Charlotte, NC 28217 | 2020-09-09 |
| 1356967749 | Optum Pharmacy 701, LLC | Pharmacy | 4015 Shopton Rd, Suite 600, Charlotte, NC 28217 | 2020-06-22 |
| 1598302937 | Brigit Boyce | Occupational Therapist | 8848 Red Oak Blvd, Ste Aa, Charlotte, NC 28217 | 2019-12-04 |
| 1275016933 | Zarah Pulfrey | Physician Assistant | Womack Medical Center, 2817 Riley Road, Fort Bragg, NC 28217 | 2018-09-10 |
| 1972085918 | Dynamic Health Medical Group Pllc | Pain Medicine | 4705 South Blvd, Charlotte, NC 28217 | 2018-09-06 |
| 1184102048 | Charday Caple | Counselor | 735 Echodale Dr, Charlotte, NC 28217 | 2018-08-02 |
| 1326532250 | Dupont Livery LLC | Non-emergency Medical Transport (VAN) | 4200 S Tryon St, Charlotte, NC 28217 | 2018-06-14 |
| 1891215232 | Lakesha Shamise Welch | Counselor | 5709 South Hampton R., Charlotte, NC 28217 | 2017-06-27 |
| 1245768282 | Allison Harris Lafone | Counselor | 515 Clanton Road, Charlotte, NC 28217 | 2017-06-02 |
| 1619416906 | Charlie Randolph Taylor Jr. | Counselor | 517 Clanton Road, Charlotte, NC 28217 | 2017-02-20 |
| Find all providers in zip 28217 | ||||
| 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 |
|---|---|---|---|---|
| 1285258244 | Royal Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 3709 Eastway Dr Ste 101, Charlotte, NC 28205-6266 | 2020-06-04 |
| 1427681667 | Prism Medical Products, L.L.C. | Durable Medical Equipment & Medical Supplies | 9635 Southern Pine Blvd Ste 100, Charlotte, NC 28273-5546 | 2020-02-17 |
| 1588204846 | Amerita South Atlantic LLC | Durable Medical Equipment & Medical Supplies | 2520 Whitehall Park Dr Ste 1000, Charlotte, NC 28273 | 2020-01-14 |
| 1710529458 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 200 Hawthorne Ln Ste T1578, Charlotte, NC 28204-2515 | 2019-10-15 |
| 1861040750 | Helen C Ananti | Durable Medical Equipment & Medical Supplies | 7401 The Plz Ste C, Charlotte, NC 28215-1925 | 2019-09-03 |
| 1407326416 | Affordable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 7200 Albemarle Rd Ste E, Charlotte, NC 28227-8110 | 2018-12-03 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1821574955 | Jeff Gauer | Durable Medical Equipment & Medical Supplies | 9517 Monroe Rd Ste H, Charlotte, NC 28270-1489 | 2018-07-11 |
| 1871089094 | Unyq Design Inc | Durable Medical Equipment & Medical Supplies | 1776 Statesville Ave # 10117, Charlotte, NC 28206-3013 | 2018-07-11 |
| 1225524671 | Jevetta R Wade | Durable Medical Equipment & Medical Supplies | 8828 Balmoral Park Dr, Charlotte, NC 28277-1338 | 2018-07-09 |
| Find all providers in CHARLOTTE | ||||
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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.