Medical Department Store – Durable Medical Equipment & Medical Supplies, NPI 1043217391

Medical Department Store is a healthcare provider. based in Venice, Florida. specializing in Durable Medical Equipment & Medical Supplies. The organization holds a License No. HME 1608 (FL). The NPI Number for Medical Department Store is 1043217391

Main info

Organization
Name
Medical Department Store
NPI
1043217391
Phone
(941) 497-2273
Address
1180 JACARANDA BLVD
Authorized Official
MR. KEVIN WILLIAM MCCORD MANAGING MEMBER
Enumeration Date
1 July 2005
Last Update Date
27 February 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Medical Department Store

  • Jacaranda Boulevard, Venice, Sarasota County, Florida, 34292, United States

    VENICE, FL 342924501

    Phone: (941) 497-2273

    Fax: (877) 497-1030

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930034546OMedical Supply CompanyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34292)

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Reviews

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Frequently asked questions

What NPI should I save for Medical Department Store?
Save NPI 1043217391 if you need a stable reference for Medical Department Store.
Is Medical Department Store active in the national directory?
Medical Department Store's public NPI profile is in an active state.
What does Medical Department Store treat or focus on?
Patients typically see Medical Department Store under the specialty Durable Medical Equipment & Medical Supplies. Clinical services aligned with this taxonomy classification.
Does Medical Department Store practice in Florida?
You will see Venice, Florida on file for Medical Department Store alongside any extra practice locations.
Is Medical Department Store a real provider?
This page reflects official NPPES data for NPI 1043217391. Always confirm identity and privileges with the practice and licensing boards.

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