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Attentive Medical Supply

NPI: 1154008894

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NPI: 1154008894

Attentive Medical Supply

Signed in as:

filler@godaddy.com

  • Home
  • Medical Professionals
  • Rentals/Repairs
  • DME/HME Products
  • Appointments

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  • Bookings
  • My Account
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Required Documents Prior to Dispensation

Fax forms to 704-781-5502 or email them to admin@attentivemedicalsupply.com. 

Physician's notes are required for all items prescribed. 


  • Prescription/Written Order
  • Phyisican's Notes/Medical Records from Patient's last face-to-face visit
  • Completed CMN/PA (see forms below)



Standard Written Order Form (pdf)Download
Hospital_Bed_CMN Form (pdf)Download
Request for Prior Approval CMNPA (NC Medicaid-372-131) 032024 ST 27957 (pdf)Download
Manual Wheelchair_CMN Form (pdf)Download
Request for Prior Approval CMNPA (NC Medicaid-372-131) (pdf)Download
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Attentive Medical Supply

12925 Highway 601 South, Ste 100, Midland, NC 28107

Phone: 704-781-5632

Copyright © 2025 Attentive Medical Supply - All Rights Reserved.

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