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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
  • Provider Referrals
  • Patients
  • Rentals & Repairs
  • DME & HME Products

Account


  • Bookings
  • My Account
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UPLOAD REFERRAL DOCUMENTS

Attentive Medical Supply partners with physicians, hospitals
SECURE UPLOAD

healthcare provider referral instructions

Submit Patient Referrals

Fax: 704-781-5502

Phone: 704-781-5632

Secure Email: admin@attentivemedicalsupply.com 


Electronic Referrals Available Through:

  • DMEconnected
  • Parachute Health

DOWNLOAD FORMS

Fax Coversheet


Prescription / Standard Written Order


Phyisican's Notes/Medical Records from Patient's last face-to-face visit


Completed CMN/PA 

Add "Attentive" after your Practice Name when registering. 


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Required Documents Prior to Dispensation

Phyisican's Notes/Medical Records from Patient's last face-to-face visit (must be within 6 months of date of prescription).

Attentive_Medical_Fax_Coversheet - Providers (pdf)Download
Standard Written Order Form (pdf)Download
Hospital_Bed_CMN Form (pdf)Download
Manual Wheelchair_CMN Form (pdf)Download
Request for Prior Approval CMNPA (NC Medicaid-372-131) (pdf)Download
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Who We Serve

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Insurance Claim Processing

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Service Areas

DME Near Me

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Common Equipment We Provide

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Attentive Medical Supply

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

Phone: 704-781-5632

Copyright © 2026 Attentive Medical Supply - All Rights Reserved.

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