Provider Demographics
NPI:1285836791
Name:NOMAD MEDICAL LLC
Entity type:Organization
Organization Name:NOMAD MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-371-8915
Mailing Address - Street 1:PO BOX 38957
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-0957
Mailing Address - Country:US
Mailing Address - Phone:901-674-7420
Mailing Address - Fax:901-677-1717
Practice Address - Street 1:2661 LOCKESLEY CV N
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38139-6826
Practice Address - Country:US
Practice Address - Phone:901-674-7420
Practice Address - Fax:901-677-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106005767332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6338480001Medicare NSC