Healthcare Provider Details

I. General information

NPI: 1093674764
Provider Name (Legal Business Name): CENTRAL PLAINS DME SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E 10TH ST
BLOOMINGTON IN
47408-3321
US

IV. Provider business mailing address

110 E 10TH ST
BLOOMINGTON IN
47408-3321
US

V. Phone/Fax

Practice location:
  • Phone: 812-345-3691
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: BRIAN MURPHY
Title or Position: MANAGER
Credential: MD
Phone: 812-345-3691