ELITE MEDICAL SUPPLY (NPI# 1043726896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043726896 |
| Entity Type | Organization |
| Organization Name | ELITE MEDICAL SUPPLY |
| Practice Address |
1166 Greenway Dr Ste A3 Jackson MO 63755-2919 |
| Practice Telephone | 5739870297 |
| Practice Fax Number | 5739870298 |
| Mailing Telephone | 5739870297 |
| Mailing Fax Number | 5739870298 |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2017-12-15 |
| Authorized Official Name | RICHARD ARRON SURFACE (OWNER) |
| Authorized Official Telephone | 5739870297 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | MO | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598243057 | Elite Medical Supply | Durable Medical Equipment & Medical Supplies | 316 Broad St Ste 2, Red Bank, NJ 07701-2155 | 2018-08-06 |
| 1235317710 | Elite Medical Supply | Durable Medical Equipment & Medical Supplies | 80 Vanderveer St, Brooklyn, NY 11207-1713 | 2008-02-06 |
| 1821076308 | Elite Medical Supply | Orthotic Fitter | 1900 Ridge Rd, West Seneca, NY 14224-3332 | 2006-01-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ELITE MEDICAL SUPPLY GROUP LLC | 332 Foster Ave, Brooklyn, New York 11230 |
| New York State Corporations | ELITE MEDICAL SUPPLY OF NEW YORK, LLC | 1900 Ridge Rd, West Seneca, New York 14224 |
| System for Award Management (SAM) Entities | ELITE MEDICAL SUPPLY, LLC | 4001 Raphune Hill Ste 106, St Thomas, VI 00802-2905 |
| Street Address |
1166 GREENWAY DR STE A3 |
| City | JACKSON |
| State | MO |
| Zip Code | 63755-2919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1215438585 | The Villas of Jackson LLC | Assisted Living Facility | 670 Broadridge, Jackson, MO 63755 | 2018-02-22 |
| 1346637865 | Vitality Clinic | Health Educator | 111 N. Missouri Street, Jackson, MO 63755 | 2015-04-22 |
| 1144569567 | Rock Care In Home Services, LLC | Nursing Care | 204 S Union Ave, Jackson, MO 63755 | 2013-02-05 |
| 1447506381 | Morgan Allyce Strand | Optometrist | 2954 E. Jackson Blvd, Jackson, MO 63755 | 2012-07-30 |
| 1154689321 | Benjamin Gail Goodier | Dentist | 3100 East Jackson Blvd., Jackson, MO 63755 | 2012-04-25 |
| 1912278987 | Guardian Angels Homecare, LLC | Nursing Care | 1335 Old Cape Rd., Suite F, Jackson, MO 63755 | 2012-01-23 |
| 1528357829 | Sydney Nicole Cheek | Technician, Other | 107 Cottonwood St., Jackson, MO 63755 | 2011-04-07 |
| 1215162920 | Troy L Bell Od & Associates, PC | Optometrist | 2594 E Jackson Blvd, Jackson, MO 63755 | 2009-05-26 |
| 1932398021 | Immediate Healthcare, Inc. | General Practice | 1508 Edgemont Blvd, Perryville, MO 63755 | 2007-10-15 |
| Find all providers in zip 63755 | ||||
| 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 |
| 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 |
| 1932570454 | Lhc Medical Supplies | Durable Medical Equipment & Medical Supplies | 5725 Highway 18 W, Jackson, MS 39209-9604 | 2015-10-09 |
| 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.