1669421798 NPI number — PEOPLES LINK MEDICAL EQUIPMENT AND SUPPLIES

Table of content: (NPI 1669421798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669421798 NPI number — PEOPLES LINK MEDICAL EQUIPMENT AND SUPPLIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEOPLES LINK MEDICAL EQUIPMENT AND SUPPLIES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669421798
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
04/02/2009
NPI Reactivation Date:
05/15/2009

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5518 DYER STREET
Provider Second Line Business Mailing Address:
#9
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-369-0400
Provider Business Mailing Address Fax Number:
214-369-0408

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5518 DYER STREET
Provider Second Line Business Practice Location Address:
#9
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-369-0400
Provider Business Practice Location Address Fax Number:
214-369-0408
Provider Enumeration Date:
05/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
IBEKE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
214-369-0400

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0088148 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 182558001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".