WEST SIDE MEDICAL SUPPLY INC (NPI# 1043597784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043597784 |
| Entity Type | Organization |
| Organization Name | WEST SIDE MEDICAL SUPPLY INC |
| Practice Address |
602 N Webb Rd Ste 108 Wichita KS 67206-1803 |
| Practice Telephone | 3166367900 |
| Practice Fax Number | 3166367939 |
| Mailing Telephone | 3166367900 |
| Mailing Fax Number | 3166367939 |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2019-11-08 |
| Authorized Official Name | DR. JUSTIN GOODEN (OWNER) |
| Authorized Official Telephone | 3166367900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 940 N Tyler Rd Ste 202, Wichita, KS 67212 | 3166367900 | 3166367939 |
| Street Address |
602 N WEBB RD STE 108 |
| City | WICHITA |
| State | KS |
| Zip Code | 67206-1803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020846 | Founders Surgery Center, LLC | Clinic/Center | 1961 N Founders Circle, Wichita, KS 67206 | 2019-12-19 |
| 1174006613 | Courtney Dawn Simon | Physical Therapist | 9360 E Central Ave Ste 100, Wichita, KS 67206 | 2018-09-11 |
| 1902308919 | Center At Waterfront LLC | Skilled Nursing Facility | 1541 North Lindberg Circle, Wichita, KS 67206 | 2018-03-06 |
| 1750804597 | Katelyn Aguiar | Psychologist | 250 N Rock Rd Ste 210, Wichita, KS 67206 | 2017-07-24 |
| 1457888778 | Mona Kay Cherryholmes | Social Worker | 1223 N. Rock Rd, Bldg A. Suite 100, Wichita, KS 67206 | 2017-05-17 |
| 1164899415 | Elizabeth Herl | Marriage & Family Therapist | 250 N Rock Rd Ste 150, Wichita, KS 67206 | 2015-08-21 |
| 1851715510 | Ndjj Corp | Custodial Care Facility | 6403 E Marjore, Wichita, KS 67206 | 2014-02-14 |
| 1801238217 | Courtney Ann Lang | Physical Therapist | 1603 North Chapel Hill Street, Suite 400, Wichita, KS 67206 | 2013-07-26 |
| 1194063032 | Peak Performance Health Pa | Chiropractor | 10111 E 21st St, #106, Wichita, KS 67206 | 2013-01-28 |
| 1750629002 | Rachel Marie Conrad | Speech-Language Pathologist | 1861 N. Rock Rd, Ste 101, Wichita, KS 67206 | 2013-01-22 |
| Find all providers in zip 67206 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396200663 | Valerie C Wondra | Durable Medical Equipment & Medical Supplies | 301 S Meridian Ave Rm 113, Wichita, KS 67213-2629 | 2019-01-31 |
| 1821411497 | Hotasan Medical Suppliers LLC | Durable Medical Equipment & Medical Supplies | 6602 E Harry St, Wichita, KS 67207-2962 | 2014-02-01 |
| 1477831212 | Cadwell Therapuetics, Inc. | Durable Medical Equipment & Medical Supplies | 1035 N Emporia St Ste 102, Wichita, KS 67214-2938 | 2011-07-27 |
| 1790071439 | All American Service | Durable Medical Equipment & Medical Supplies | 208 S Bleckley Dr, Wichita, KS 67218-1522 | 2011-06-21 |
| 1336433531 | United Seating and Mobility LLC | Durable Medical Equipment & Medical Supplies | 3450 N. Rock Road, Building 500 Suites 504-505, Wichita, KS 67226-1355 | 2011-06-06 |
| 1619205937 | Anderson Industries, Inc. | Durable Medical Equipment & Medical Supplies | 3242 W 13th St N, Suite 500, Wichita, KS 67203-6654 | 2009-11-24 |
| 1548393143 | Independent Living Resource Center | Durable Medical Equipment & Medical Supplies | 3033 W 2nd St N, Wichita, KS 67203-5357 | 2007-03-13 |
| 1568507127 | Cerebral Palsy Research Foundation of Kansas, Inc | Durable Medical Equipment & Medical Supplies | 5111 E 21st St N, Wichita, KS 67208-1606 | 2007-02-21 |
| 1629137260 | Advacare Medical Corporation | Durable Medical Equipment & Medical Supplies | 938a S Oliver St, Wichita, KS 67218-3216 | 2006-12-08 |
| 1366422586 | Firstcare Inc | Durable Medical Equipment & Medical Supplies | 625 N Carriage Pkwy, Ste 180, Wichita, KS 67208-4510 | 2006-01-23 |
| Find all providers in WICHITA | ||||
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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.