1316178841 NPI number — MID-CITIES HOME MEDICAL EQUIP. CO. INC.

Table of content: (NPI 1316178841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316178841 NPI number — MID-CITIES HOME MEDICAL EQUIP. CO. INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MID-CITIES HOME MEDICAL EQUIP. CO. INC.
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:
HOMEPOINT DME
Provider Other Organization Name Type Code:
5
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:
1316178841
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3011 RED HAWK DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND PRAIRIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-641-7445
Provider Business Mailing Address Fax Number:
972-641-7465

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6920 WOODWAY DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODWAY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-399-0029
Provider Business Practice Location Address Fax Number:
254-399-9307
Provider Enumeration Date:
07/31/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BIGBY
Authorized Official First Name:
TRACY
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OPERATIONS MANAGER
Authorized Official Telephone Number:
972-641-7445

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  BEDDING-0010654 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X , with the licence number: FOOD&DRUG0036337 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 016886601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 530511 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 531150 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".