Provider Demographics
NPI:1457331225
Name:CAMDEN MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:CAMDEN MEDICAL SUPPLY INC
Other - Org Name:MARSHALLS HOME MEDICAL EQUIPMENT & RESPIRATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MENCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-822-4600
Mailing Address - Street 1:PO BOX 27968
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0968
Mailing Address - Country:US
Mailing Address - Phone:407-246-1226
Mailing Address - Fax:407-648-2297
Practice Address - Street 1:2038 N JACKSON
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2056
Practice Address - Country:US
Practice Address - Phone:870-234-7434
Practice Address - Fax:870-234-7060
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROTECH HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1689629Medicaid
AR230300737Medicaid
AR127543716Medicaid
AR127543716Medicaid