DEDRA MATOYA ROBERTSON (NPI# 1104388701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104388701 |
| Entity Type | Individual |
| Full Name | DEDRA MATOYA ROBERTSON |
| Practice Address |
110 Beasley St Andalusia AL 36420-4957 |
| Practice Telephone | 3348923784 |
| Mailing Telephone | 3348923784 |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-04-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
23190424 | AL | Suppliers |
| Street Address |
110 BEASLEY ST |
| City | ANDALUSIA |
| State | AL |
| Zip Code | 36420-4957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487184289 | Amber Bryant Seay | Pharmacist | 1991 Mlk Expressway, Andalusia, AL 36420 | 2017-06-14 |
| 1780114587 | Jenifer Harper Stanford | Pharmacist | 1991 M.l. King Jr. Expressway, Andalusia, AL 36420 | 2017-06-14 |
| 1306379797 | Therapy South Andalusia LLC | Physical Therapist | 811 B West Bypass, Andalusia, AL 36420 | 2017-04-04 |
| 1205207685 | Christina Mullen | Hearing Instrument Specialist | 504b East Three Notch St, Andalusia, AL 36420 | 2015-10-12 |
| 1831526029 | Jana M. Mallder | Nurse Practitioner | 508 E Three Notch St # 100, Andalusia, AL 36420 | 2013-10-02 |
| 1902153232 | Alabama Cvs Pharmacy L L C | Durable Medical Equipment & Medical Supplies | 1204 Dr Mlk Expressway, Audalusia, AL 36420 | 2012-08-06 |
| 1457644320 | Christian Sanders Bentley | Pharmacist | 1017 River Falls Street, Andalusia, AL 36420 | 2011-05-25 |
| 1306152624 | James L Barton LLC | Optometrist | 500 Westgate Plaza, Andalusia, AL 36420 | 2010-08-24 |
| 1538337035 | Olive Tree Healthcare PC | Internal Medicine | 301 Medical Avenue, Suite B, Andalusia, AL 36420 | 2008-02-19 |
| 1528255601 | Vyas & Vyas PC (change) | Internal Medicine | 1212 East Three Notch Street, Andalusia, AL 36420 | 2007-10-02 |
| Find all providers in zip 36420 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245875491 | Milan Hair Collection | Durable Medical Equipment & Medical Supplies | 205b Church St, Andalusia, AL 36420-3701 | 2019-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457966087 | Tusk Mobility | Durable Medical Equipment & Medical Supplies | 1000 Union Chapel Rd E # 14, Northport, AL 35473-7615 | 2020-09-10 |
| 1124653423 | Freedom In Mobility | Durable Medical Equipment & Medical Supplies | 1315 Fletcher St Nw Ste B, Huntsville, AL 35801-4665 | 2020-03-06 |
| 1578020004 | Medical Supply Dme LLC | Durable Medical Equipment & Medical Supplies | 2400 Promenade Blvd Apt 2, Montgomery, AL 36106-4001 | 2019-02-20 |
| 1649799701 | Rdg Team, LLC | Durable Medical Equipment & Medical Supplies | 6600 Walt Dr Ste E, Birmingham, AL 35242-7150 | 2017-09-10 |
| 1871024133 | Kamilah Harper | Durable Medical Equipment & Medical Supplies | 1420 Paramount Dr, Suite G, Huntsville, AL 35806-2833 | 2017-03-27 |
| 1588105035 | Tmj & Sleep Solutions of Alabama Inc | Durable Medical Equipment & Medical Supplies | 1045 Broadway Park Ste 109, Birmingham, AL 35209-6256 | 2017-03-16 |
| 1275072266 | Jennifer E Todd | Durable Medical Equipment & Medical Supplies | 316 S Mckenzie St Ste 171, Foley, AL 36535-1980 | 2017-02-23 |
| 1558749630 | Tommie Rodgers | Durable Medical Equipment & Medical Supplies | 210 Shady Oak St, Saraland, AL 36571-9432 | 2015-05-11 |
| 1952708034 | Complete Feet, LLC | Durable Medical Equipment & Medical Supplies | 2811 18th St S, Homewood, AL 35209-2509 | 2014-12-04 |
| 1871990929 | Mcconaghy Home Medical, LLC | Durable Medical Equipment & Medical Supplies | 16900 Jordan Street, Suite B, Chatom, AL 36518 | 2014-12-04 |
| Find all providers with the same taxonomy | ||||
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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.