Basic Information
| Provider Information | |||||||||
| NPI: | 1831195551 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MAJORS MEDICAL SUPPLY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 17279 | ||||||||
| Address2: | |||||||||
| City: | ESMOND | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029170418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012317100 | ||||||||
| FaxNumber: | 4012310763 | ||||||||
| Practice Location | |||||||||
| Address1: | 197 PUTNAM PIKE | ||||||||
| Address2: | |||||||||
| City: | JOHNSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029191468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012317100 | ||||||||
| FaxNumber: | 4012310763 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BRADLEY | ||||||||
| AuthorizedOfficialFirstName: | DAMON | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4012317100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |
ID Information
| ID | Type | State | Issuer | Description | 4766855002 | 01 | RI | CIGNA | OTHER | 625455 | 01 | RI | TRIGON | OTHER | 28025 | 01 | RI | NHP | OTHER | 7572-7 | 01 | RI | BLUE CROSS RI | OTHER | 8180001 | 05 | RI | MEDICAID | 87726 | 01 | RI | UHP | OTHER | Z63204 | 01 | MA | MA BLUE CROSS | OTHER |