MARTHA DALE KRISTIANSEN (NPI# 1629257084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629257084 |
| Entity Type | Organization |
| Organization Name | MARTHA DALE KRISTIANSEN |
| Other Organization Name | MAK MEDICAL EQUIPMENT & RESPIRATORY |
| Practice Address |
1413 Aston Ave Mccomb MS 39648-2827 |
| Practice Telephone | 6016845115 |
| Practice Fax Number | 6016845116 |
| Mailing Telephone | 6016845115 |
| Mailing Fax Number | 6016845116 |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2008-08-12 |
| Authorized Official Name | MRS. MARTHA DALE KRISTIANSEN (OWNER) |
| Authorized Official Telephone | 6016845115 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
057128480 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00440487 | 05 | |
| MS | ABP | 9000 | 01 |
| Other Name | Type Code |
|---|---|
| MAK MEDICAL EQUIPMENT & RESPIRATORY | Doing Business As Name - Organization |
| Street Address |
1413 ASTON AVE |
| City | MCCOMB |
| State | MS |
| Zip Code | 39648-2827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910366 | Ct Stamps Inc | Pharmacy | 206 Marion Avenue, Mccomb, MS 39648 | 2020-07-31 |
| 1952910457 | Fresenius Medical Care East Mccomb Dialysis, LLC | Clinic/Center | 103 Business Center Drive, Mccomb, MS 39648 | 2020-07-30 |
| 1902423312 | Joseph Edward Mingo II | Counselor | 513 Lee St, Mccomb, MS 39648 | 2020-07-01 |
| 1427608769 | Benda Truvillion | Technician | 2128 Park Dr. Ext., Mccomb, MS 39648 | 2019-09-18 |
| 1295228187 | Edna Ruth Winston | Counselor | Sw Ms Mental Health Complex, 1701 White St, Mccomb, MS 39648 | 2018-06-14 |
| 1386153450 | Sholitha Nunnery | Counselor | 502 North Cherry Street, Mccomb, MS 39648 | 2017-09-21 |
| 1548600612 | Jordan Harrington | Nurse Practitioner | 303 Marion Ave., Mccomb, MS 39648 | 2013-07-03 |
| 1891096236 | Zwound Care | Family Medicine | 1126 Country Club Road, Mccomb, MS 39648 | 2010-11-16 |
| 1588891717 | Kelly Edmondson | Physical Therapy Assistant | 1301a Harrison Ave, Mccomb, MS 39648 | 2009-06-15 |
| 1962647651 | Gwendolyn Michelle Brown | Home Health Aide | 1114 1/2 Venable St., Mccomb, MS 39648 | 2008-12-09 |
| Find all providers in zip 39648 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790985406 | Ms Medical Supplies, Inc. | Durable Medical Equipment & Medical Supplies | 1709 Delaware Ave, Mccomb, MS 39648-3636 | 2007-07-20 |
| 1336203819 | Tri-state Medical Home Health | Durable Medical Equipment & Medical Supplies | 612 Delaware Ave, Suite 18, Mccomb, MS 39648-4000 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1790324614 | Aerocare Home Medical, Inc. | Durable Medical Equipment & Medical Supplies | 2210 Mill Street Ext Ste E, Lucedale, MS 39452-6079 | 2019-12-23 |
| 1487291977 | Aerocare Home Medical, Inc. | Durable Medical Equipment & Medical Supplies | 2210 Mill Street Ext Ste F, Lucedale, MS 39452-6079 | 2019-12-04 |
| 1699311654 | Aerocare Home Medical, Inc. | Durable Medical Equipment & Medical Supplies | 6555 U S Highway 98 Ste 5b, Hattiesburg, MS 39402-7625 | 2019-11-25 |
| 1407402381 | Elite Medical Care, LLC | Durable Medical Equipment & Medical Supplies | 103 Woodland Rd Ste 3, Batesville, MS 38606-8483 | 2019-08-15 |
| 1396305892 | Regional Health Services LLC | Durable Medical Equipment & Medical Supplies | 920 E Mcdowell Rd, Jackson, MS 39204-5911 | 2019-06-17 |
| 1396219325 | Tri-state Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 6392 Highway 51 N, Pope, MS 38658-2421 | 2019-01-12 |
| 1801256508 | Down Home Medical Supply | Durable Medical Equipment & Medical Supplies | 2691 Highway 15, Bay Springs, MS 39422-7431 | 2016-02-24 |
| 1003214198 | Cook Wholesale Co Inc | Durable Medical Equipment & Medical Supplies | 404 Highway 16 E, Carthage, MS 39051-4208 | 2014-12-05 |
| 1659719557 | Lexington Medical Supply | Durable Medical Equipment & Medical Supplies | 22743 Highway 12, Lexington, MS 39095-3118 | 2013-06-13 |
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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.