THE MED SHOP (NPI# 1124116561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124116561 |
| Entity Type | Organization |
| Organization Name | THE MED SHOP |
| Practice Address |
110 N . Walnut Jefferson TX 75657 |
| Mailing Address |
110 N Walnut Jefferson TX 75657 |
| Practice Telephone | 9036652525 |
| Practice Fax Number | 9036652526 |
| Mailing Telephone | 9036652525 |
| Mailing Fax Number | 9036652526 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GEORGE E TEEL (OWNER) |
| Authorized Official Telephone | 9036393508 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
25114 | TX | Suppliers |
| X | 333600000X | Pharmacy | 25114 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | PHARMACY | 25114 | 01 |
| Street Address |
110 N . WALNUT |
| City | JEFFERSON |
| State | TX |
| Zip Code | 75657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780131995 | Kimberly George | Case Manager/Care Coordinator | 261 Ma County Road 3430, Jefferson, TX 75657 | 2016-09-06 |
| 1487644068 | Denise Sepulvado Norris | Occupational Therapist | 1404 Marion County Road 3509, Jefferson, TX 75657 | 2005-10-25 |
| 1700870185 | Robin Lynne Gale | Nurse Practitioner | 219 N Polk St, Jefferson, TX 75657 | 2005-08-31 |
| 1700072477 | James Leo Carroll | Physical Therapy Assistant | 339 Tangiers, Jefferson, TX 75657-0598 | 2007-09-17 |
| 1952397739 | Pine Hill Nursing and Rehabilitation Lp | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2005-09-27 |
| 1124495486 | Fannin County Hospital Authority | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2015-08-21 |
| 1598910291 | Jefferson I Enterprises, LLC | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2008-11-21 |
| 1558404293 | Jefferson Isd | Local Education Agency (LEA) | 1600 Martin Luther King Dr, Jefferson, TX 75657-1061 | 2007-02-14 |
| 1730352667 | Demetria Rena Parker | Nurse's Aide | 506 E Harrison St, Jefferson, TX 75657-1106 | 2008-04-11 |
| 1114985876 | Good Shepherd Medical Center - Linden, Inc | Clinic/Center | 903 N Walcott St, Jefferson, TX 75657-1128 | 2006-05-03 |
| Find all providers in zip 75657 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760488548 | Noah's Ark Homecare, Inc. | Durable Medical Equipment & Medical Supplies | 1530 Rambler Inn Rd, Jefferson, GA 30549-5625 | 2005-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897735 | Extraordinary Home Health Care LLC | Durable Medical Equipment & Medical Supplies | 754 Bateswood Dr Apt 4, Houston, TX 77079-5711 | 2020-09-24 |
| 1013527290 | Riptide Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2408 Lexington Pl, Brownsville, TX 78520-3914 | 2020-08-03 |
| 1790300457 | United Wellness Dme LLC | Durable Medical Equipment & Medical Supplies | 2611 N Texas Blvd Ste 3, Weslaco, TX 78599-4062 | 2020-06-09 |
| 1831711969 | Brightstar Medical Supply | Durable Medical Equipment & Medical Supplies | 1006 N Sylvania Ave, Fort Worth, TX 76111-2516 | 2020-05-12 |
| 1568099232 | Manuel F Huaman | Durable Medical Equipment & Medical Supplies | 19842 Portlick Ct, Katy, TX 77449-5737 | 2020-03-24 |
| 1265076806 | Stateserv Medical of Texas | Durable Medical Equipment & Medical Supplies | 1207 N. Glenview Drive, Richardson, TX 75081 | 2019-11-06 |
| 1124673942 | Integrity Dme Services LLC | Durable Medical Equipment & Medical Supplies | 6323 Sovereign Dr, Suite # 170 Ab, San Antonio, TX 78229 | 2019-08-08 |
| 1649823550 | Thomas Edward Potter | Durable Medical Equipment & Medical Supplies | 135 Bonner Ave, Corsicana, TX 75110-9252 | 2019-07-19 |
| 1114587912 | Curtis Downey | Durable Medical Equipment & Medical Supplies | 4914 Winnetka St, Houston, TX 77021-2932 | 2019-06-14 |
| 1700443330 | Leticia Garcia | Durable Medical Equipment & Medical Supplies | 12077 Briargrove Ln, Forney, TX 75126-4132 | 2019-05-20 |
| 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.