1831496827 NPI number — MEDICAL EQUIPMENT DISTRIBUTORS II LP

Table of content: (NPI 1831496827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831496827 NPI number — MEDICAL EQUIPMENT DISTRIBUTORS II LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL EQUIPMENT DISTRIBUTORS II LP
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:
THE MED GROUP
Provider Other Organization Name Type Code:
3
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:
1831496827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3223 S LOOP 289
Provider Second Line Business Mailing Address:
SUITE 600
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79423-1337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-825-5633
Provider Business Mailing Address Fax Number:
806-792-4499

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3300 82ND ST
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79423-2045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-797-5280
Provider Business Practice Location Address Fax Number:
806-797-5290
Provider Enumeration Date:
02/28/2011

Additional Information

Authorized Official

Authorized Official Last Name:
WOODHAM
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VICE PRESIDENT & GENERAL MAN
Authorized Official Telephone Number:
800-825-5633

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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