SUPERMOMMY'S SUPERSTORE, LLC (NPI# 1639305709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639305709 |
| Entity Type | Organization |
| Organization Name | SUPERMOMMY'S SUPERSTORE, LLC |
| Other Organization Name | SUPERMOMMY'S SUPERSTORE |
| Practice Address |
2411 Ring Rd Suite 105 Elizabethtown KY 42701-5929 |
| Mailing Address |
Po Box 268 Rineyville KY 40162-0268 |
| Practice Telephone | 2707696693 |
| Practice Fax Number | 2707690911 |
| Mailing Telephone | 2707696693 |
| Mailing Fax Number | 2707690911 |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2009-06-03 |
| Authorized Official Name | MRS. REGINA RAE HAGAN (OWNER) |
| Authorized Official Telephone | 2707696693 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Supermommy's Superstore | Doing Business As Name - Organization |
| Street Address |
2411 RING RD SUITE 105 |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-5929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043686371 | Shaun Milby | Nurse Practitioner | 2411 Ring Rd, Suite 114, Elizabethtown, KY 42701-5929 | 2015-08-21 |
| 1053694463 | Jg Connections Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2411 Ring Rd, Suite 102, Elizabethtown, KY 42701-5929 | 2011-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| 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 |
|---|---|---|---|---|
| 1043838014 | Restoration Dme Supplies, LLC | Durable Medical Equipment & Medical Supplies | 326 N Mulberry St Ste 105, Elizabethtown, KY 42701-1880 | 2020-07-07 |
| 1255896015 | Andersons Drug Store LLC | Durable Medical Equipment & Medical Supplies | 206 S. Poplar St., Elizabethtown, NC 28337 | 2019-02-06 |
| 1184046690 | Allium Tricoccum LLC | Durable Medical Equipment & Medical Supplies | 27 Cobble Ln, Elizabethtown, PA 17022-8838 | 2014-01-17 |
| 1679904270 | Kentucky Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1571 N Dixie Hwy, Elizabethtown, KY 42701-2653 | 2013-12-06 |
| 1295020741 | Etown Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 914 N Dixie Ave Ste 103, Elizabethtown, KY 42701-2536 | 2011-06-13 |
| 1194028167 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 550 W Dixie Ave, Elizabethtown, KY 42701-2468 | 2010-12-14 |
| 1942341391 | Apothecare Pharmacy of Elizabethtown P S C | Durable Medical Equipment & Medical Supplies | 1028 N Dixie Ave Ste 100, Elizabethtown, KY 42701-2522 | 2007-02-09 |
| 1366590804 | Sleep Source Inc | Durable Medical Equipment & Medical Supplies | 585 Westport Rd # C, Elizabethtown, KY 42701-2949 | 2007-01-08 |
| 1992879043 | Eugene Teufel & Son Orthotics and Prosthetics Inc | Durable Medical Equipment & Medical Supplies | 915 N Hanover St, Elizabethtown, PA 17022-1306 | 2006-11-20 |
| 1619076296 | Lincoln Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 1815 N Dixie Hwy, Suite 1, Elizabethtown, KY 42701-9424 | 2006-09-21 |
| Find all providers in ELIZABETHTOWN | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
Please comment or provide details below to improve the information on SUPERMOMMY'S SUPERSTORE, LLC.
| 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.