Provider Demographics
NPI:1164524146
Name:ON-CALL MEDICAL EQUIPMENT AND SUPPLY, INC.
Entity Type:Organization
Organization Name:ON-CALL MEDICAL EQUIPMENT AND SUPPLY, INC.
Other - Org Name:ON CALL MEDICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-449-6190
Mailing Address - Street 1:337 S CUMBERLAND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3605
Mailing Address - Country:US
Mailing Address - Phone:615-449-6190
Mailing Address - Fax:615-449-6208
Practice Address - Street 1:337 S CUMBERLAND ST
Practice Address - Street 2:SUITE B
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3605
Practice Address - Country:US
Practice Address - Phone:615-449-6190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000031023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4430257OtherNCPDP
TN1452131Medicaid
TN1452131Medicaid
TN0677030002Medicare ID - Type Unspecified