MEDISERVE MEDICAL EQUIPMENT OF KINGSPORT, INC (NPI# 1992880876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992880876 |
| Entity Type | Organization |
| Organization Name | MEDISERVE MEDICAL EQUIPMENT OF KINGSPORT, INC |
| Practice Address |
444 Clinchfield St Ste 2201 Kingsport TN 37660-3858 |
| Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
| Practice Telephone | 4232456102 |
| Practice Fax Number | 4232456612 |
| Mailing Telephone | 4232456102 |
| Mailing Fax Number | 4232456612 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2019-01-26 |
| Authorized Official Name | MARY LYNN KRUTAK (EVP/CFO) |
| Authorized Official Telephone | 4233023423 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1454286 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528143492 | Mediserve Medical Equipment of Kingsport, Inc | Durable Medical Equipment & Medical Supplies | 1406 Tusculum Blvd Ste 2001, Greeneville, TN 37745-4337 | 2006-10-26 |
| Street Address |
444 CLINCHFIELD ST STE 2201 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-3858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| 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 |
|---|---|---|---|---|
| 1801436365 | Amerita South Atlantic LLC | Durable Medical Equipment & Medical Supplies | 105 Jack White Dr Ste B, Kingsport, TN 37664-2364 | 2020-01-13 |
| 1245542737 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 130 W Ravine Rd Ste 101, Kingsport, TN 37660-3837 | 2010-07-13 |
| 1376876904 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 2790 E Stone Dr, Kingsport, TN 37660-5849 | 2009-09-15 |
| 1073707154 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2626 E Stone Dr Ste 90, Kingsport, TN 37660-5883 | 2007-08-31 |
| 1649344797 | Hanger Prosthetics & Orthotics Inc | Durable Medical Equipment & Medical Supplies | 2633 E Stone Dr Ste C & D, Kingsport, TN 37660-5921 | 2006-11-20 |
| 1316022296 | Mediserve Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 3200 Ft Henry Dr, Kingsport, TN 37664 | 2006-10-26 |
| 1760580609 | Mac's Medicine Mart, Inc | Durable Medical Equipment & Medical Supplies | 1455 E Center St, Kingsport, TN 37664-2501 | 2006-09-21 |
| 1710080445 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5215 Memorial Blvd, Suite 20, Kingsport, TN 37664 | 2006-09-07 |
| 1114932134 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1420 W Stone Dr, Kingsport, TN 37660-2522 | 2006-07-29 |
| 1588679500 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2200 Memorial Blvd, Kingsport, TN 37664-3385 | 2006-07-29 |
| Find all providers in KINGSPORT | ||||
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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.