MEDISTAT, INC (NPI# 1932249075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932249075 |
| Entity Type | Organization |
| Organization Name | MEDISTAT, INC |
| Practice Address |
935 Old Humboldt Rd Suite A Jackson TN 38305-9625 |
| Mailing Address |
Po Box 10728 Jackson TN 38308-0112 |
| Practice Telephone | 7316600060 |
| Practice Fax Number | 7316600622 |
| Mailing Telephone | 7316600060 |
| Mailing Fax Number | 7316600622 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2013-09-23 |
| Authorized Official Name | MR. DAVID B SCOTT (PRESIDENT & CEO) |
| Authorized Official Telephone | 7316600060 |
| Authorized Official Credential | MBA, ATP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 0000000806 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS BLUE SHIELD | 104735 | 01 |
| TN | 3558573 | 05 |
| Street Address |
935 OLD HUMBOLDT RD SUITE A |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-9625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811054117 | Alphamed, Inc | Durable Medical Equipment & Medical Supplies | 935 Old Humboldt Rd, Suite A, Jackson, TN 38305-9625 | 2007-01-03 |
| 1760631717 | Alphasleep Laboratories, LLC | Clinic/Center | 935 Old Humboldt Rd, Ste C, Jackson, TN 38305-9625 | 2008-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| 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 |
|---|---|---|---|---|
| 1700432754 | Encore Care Inc | Durable Medical Equipment & Medical Supplies | 55 N County Line Rd Ste 6, Jackson, NJ 08527-1394 | 2019-08-15 |
| 1720542855 | Jea Optical LLC | Durable Medical Equipment & Medical Supplies | 1200 N State St Ste 110, Jackson, MS 39202-2027 | 2019-01-23 |
| 1689142317 | 3 B Labs | Durable Medical Equipment & Medical Supplies | 3011 Greystone Sq, Jackson, TN 38305-3590 | 2018-11-12 |
| 1043726896 | Elite Medical Supply | Durable Medical Equipment & Medical Supplies | 1166 Greenway Dr Ste A3, Jackson, MO 63755-2919 | 2017-12-15 |
| 1124551205 | Quincy Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 5303 Old Cape Rd E Ste A, Jackson, MO 63755-3850 | 2017-04-06 |
| 1295277952 | G & N Enterprise, LLC | Durable Medical Equipment & Medical Supplies | 460 Briarwood Dr Ste 100, Jackson, MS 39206-3053 | 2016-11-12 |
| 1417305665 | J.u.s.t. Orthotics | Durable Medical Equipment & Medical Supplies | 1020 Aspen Dr, Jackson, MO 63755-1152 | 2016-05-27 |
| 1710332325 | Apex Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 189 N Lacey St, Suite 2, Jackson, MO 63755-2496 | 2016-05-02 |
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1285099192 | At-home Medical Supply | Durable Medical Equipment & Medical Supplies | 5015 I 55 N Ste B, Jackson, MS 39206-4306 | 2015-12-18 |
| Find all providers in JACKSON | ||||
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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.